Drug_NDC|Drug_cpa_name|Drug_cpa_description|Drug_cpa_EffDate|Drug_cpa_EndDate 00002143380|CE:DPP-SAX5|DPP-4 Inhibitors|09/25/2018| 00002143380|CE:GLP-GLP|GLP-1 Receptor Agonists|09/25/2018| 00002143480|CE:DPP-SAX5|DPP-4 Inhibitors|09/25/2018| 00002143480|CE:GLP-GLP|GLP-1 Receptor Agonists|09/25/2018| 00002144509|CE:CYC-TALT|Cytokine and CAM Antagonists|03/27/2018| 00002144511|CE:CYC-TALT|Cytokine and CAM Antagonists|03/27/2018| 00002144527|CE:CYC-TALT|Cytokine and CAM Antagonists|03/27/2018| 00002322730|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 00002322830|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 00002322930|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 00002323030|CE:APY-SGA|Antipsychotics|04/10/2016| 00002323130|CE:APY-SGA|Antipsychotics|04/10/2016| 00002323330|CE:APY-SGA|Antipsychotics|04/10/2016|03/31/2021 00002323430|CE:APY-SGA|Antipsychotics|04/10/2016|03/31/2021 00002323830|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 00002323930|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 00002325030|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 00002325130|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 00002411230|CE:APY-SGA|Antipsychotics|04/10/2016| 00002411230|CE:DRO-OLANZ2.5|Drug Regimen Optimization|01/31/2011| 00002411530|CE:APY-SGA|Antipsychotics|04/10/2016| 00002411530|CE:DRO-OLANZ5|Drug Regimen Optimization|01/31/2011| 00002411630|CE:DRO-OLANZ7.5|Drug Regimen Optimization|01/31/2011| 00002411630|CE:APY-SGA|Antipsychotics|04/10/2016| 00002411730|CE:APY-SGA|Antipsychotics|04/10/2016| 00002411730|CE:DRO-OLANZ10|Drug Regimen Optimization|01/31/2011| 00002418230|CE:CYC-OLU|Cytokine and CAM Antagonists|06/25/2019| 00002418402|CE:DUP-RXF|Duplicate Therapy|02/04/2016| 00002418430|CE:DUP-RXF|Duplicate Therapy|02/04/2016| 00002441530|CE:APY-SGA|Antipsychotics|04/10/2016| 00002442030|CE:APY-SGA|Antipsychotics|04/10/2016| 00002445385|CE:APY-SGA|Antipsychotics|04/10/2016| 00002445385|CE:DRO-OLAODT5|Drug Regimen Optimization|01/31/2011| 00002445485|CE:DRO-OLAODT10|Drug Regimen Optimization|01/31/2011| 00002445485|CE:APY-SGA|Antipsychotics|04/10/2016| 00002445585|CE:APY-SGA|Antipsychotics|04/10/2016| 00002445685|CE:APY-SGA|Antipsychotics|04/10/2016| 00002473230|CE:CYC-OLU|Cytokine and CAM Antagonists|06/25/2019| 00002733511|CE:GRH-NPGROWTH|Growth Hormones|01/31/2011|09/30/2021 00002759701|CE:APY-SGA|Antipsychotics|04/10/2016| 00002763511|CE:APY-SGA|Antipsychotics|04/10/2016| 00002763611|CE:APY-SGA|Antipsychotics|04/10/2016| 00002763711|CE:APY-SGA|Antipsychotics|04/10/2016| 00002771459|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00002772401|CE:CYC-TALT|Cytokine and CAM Antagonists|03/27/2018| 00002772411|CE:CYC-TALT|Cytokine and CAM Antagonists|03/27/2018| 00002775205|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00002814701|CE:GRH-NPGROWTH|Growth Hormones|01/31/2011| 00002814801|CE:GRH-NPGROWTH|Growth Hormones|01/31/2011| 00002814901|CE:GRH-NPGROWTH|Growth Hormones|01/31/2011| 00003089321|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00003089331|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00003089421|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00003089431|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00003089470|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00003218811|CE:CYC-OREN|Cytokine and CAM Antagonists|03/27/2018| 00003218851|CE:CYC-OREN|Cytokine and CAM Antagonists|03/27/2018| 00003281411|CE:CYC-OREN|Cytokine and CAM Antagonists|03/27/2018| 00003281811|CE:CYC-OREN|Cytokine and CAM Antagonists|03/27/2018| 00003376474|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00003517805|CE:DRO-PRAVA20|Drug Regimen Optimization|01/31/2011|10/31/2021 00003517805|CE:DUP-STN|Duplicate Therapy|02/04/2016|10/31/2021 00003519410|CE:DRO-PRAVA40|Drug Regimen Optimization|01/31/2011|10/31/2021 00003519410|CE:DUP-STN|Duplicate Therapy|02/04/2016|10/31/2021 00004005801|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00004005801|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00004005801|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00004005801|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00004006801|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00004006801|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00004006801|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00004006801|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00004009801|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00004009801|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00004009801|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00004009801|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00006000530|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00006003330|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00006007861|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 00006007862|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 00006007882|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 00006008061|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 00006008062|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 00006008082|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 00006008131|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 00006008154|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 00006008182|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 00006011231|CE:STG-JNVA50|Sitagliptan (Januvia)|01/31/2011| 00006011231|CE:DPP-STG50|DPP-4 Inhibitors|09/25/2018| 00006011231|CE:DRO-SITAG50|Drug Regimen Optimization|01/31/2011| 00006011254|CE:DPP-STG50|DPP-4 Inhibitors|09/25/2018| 00006011254|CE:DRO-SITAG50|Drug Regimen Optimization|01/31/2011| 00006011254|CE:STG-JNVA50|Sitagliptan (Januvia)|01/31/2011| 00006022131|CE:DRO-SITAG25|Drug Regimen Optimization|01/31/2011| 00006022131|CE:DPP-STG25|DPP-4 Inhibitors|09/25/2018| 00006022131|CE:STG-JNVA25|Sitagliptan (Januvia)|01/31/2011| 00006022154|CE:DPP-STG25|DPP-4 Inhibitors|09/25/2018| 00006022154|CE:STG-JNVA25|Sitagliptan (Januvia)|01/31/2011| 00006022154|CE:DRO-SITAG25|Drug Regimen Optimization|01/31/2011| 00006027728|CE:STG-JNVA100|Sitagliptan (Januvia)|01/31/2011| 00006027728|CE:DPP-STG100|DPP-4 Inhibitors|09/25/2018| 00006027731|CE:STG-JNVA100|Sitagliptan (Januvia)|01/31/2011| 00006027731|CE:DPP-STG100|DPP-4 Inhibitors|09/25/2018| 00006027754|CE:DPP-STG100|DPP-4 Inhibitors|09/25/2018| 00006027754|CE:STG-JNVA100|Sitagliptan (Januvia)|01/31/2011| 00006027782|CE:STG-JNVA100|Sitagliptan (Januvia)|01/31/2011| 00006027782|CE:DPP-STG100|DPP-4 Inhibitors|09/25/2018| 00006032530|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00006033530|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00006046102|CE:AEM-ANTIEME|Antiemetics Oral|01/31/2011| 00006046405|CE:AEM-ANTIEME|Antiemetics Oral|01/31/2011|10/31/2020 00006046410|CE:AEM-ANTIEME|Antiemetics Oral|01/31/2011| 00006054331|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00006054354|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00006057561|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 00006057562|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 00006057582|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 00006057761|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 00006057762|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 00006057782|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 00006071731|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00006071731|CE:DRO-LORS12.5|Drug Regimen Optimization|01/31/2011| 00006071731|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00006071754|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00006071754|CE:DRO-LORS12.5|Drug Regimen Optimization|01/31/2011| 00006071754|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00006073531|CE:DRO-SIMVA10|Drug Regimen Optimization|01/31/2011| 00006073531|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00006073554|CE:DRO-SIMVA10|Drug Regimen Optimization|01/31/2011| 00006073554|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00006074031|CE:DRO-SIMVA20|Drug Regimen Optimization|01/31/2011| 00006074031|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00006074054|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00006074054|CE:DRO-SIMVA20|Drug Regimen Optimization|01/31/2011| 00006074531|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00006074531|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00006074554|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00006074554|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00006074731|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00006074731|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00006074754|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00006074754|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00006074931|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00006074931|CE:DRO-SIMVA40|Drug Regimen Optimization|01/31/2011| 00006074954|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00006074954|CE:DRO-SIMVA40|Drug Regimen Optimization|01/31/2011| 00006095154|CE:DRO-LORSA25|Drug Regimen Optimization|01/31/2011| 00006095154|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00006095231|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00006095231|CE:DRO-LORSA50|Drug Regimen Optimization|01/31/2011| 00006095254|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00006095254|CE:DRO-LORSA50|Drug Regimen Optimization|01/31/2011| 00006096031|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00006096054|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00006171131|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 00006307402|CE:HCA-HEPC|Hepatitis C Agents Clinical|01/23/2015| 00006384130|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 00006386203|CE:AEM-ANTIEME|Antiemetics Oral|01/31/2011| 00006536703|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 00006536706|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 00006536803|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 00006536806|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 00006911731|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 00006911754|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 00006927531|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 00007337013|CE:DRO-CARVCR10|Drug Regimen Optimization|01/31/2011|05/13/2021 00007337113|CE:DRO-CARVCR20|Drug Regimen Optimization|01/31/2011|10/21/2021 00007337213|CE:DRO-CARVCR40|Drug Regimen Optimization|01/31/2011|10/14/2021 00007365022|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00008083321|CE:DRO-VENL75|Drug Regimen Optimization|01/31/2011| 00008083322|CE:DRO-VENL75|Drug Regimen Optimization|01/31/2011| 00008083721|CE:DRO-VENL37.5|Drug Regimen Optimization|01/31/2011| 00008083722|CE:DRO-VENL37.5|Drug Regimen Optimization|01/31/2011| 00008084381|CE:DRO-PNZ20|Drug Regimen Optimization|01/31/2011| 00008112312|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00009001201|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00009001201|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00009002201|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00009002201|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00009002901|CE:ALP-ALP|Alprazolam|05/28/2015| 00009002901|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00009002901|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00009002901|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00009002902|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00009002902|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00009002902|CE:ALP-ALP|Alprazolam|05/28/2015| 00009002902|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00009003101|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00009003101|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00009004401|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00009004401|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00009005501|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00009005501|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00009005501|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00009005501|CE:ALP-ALP|Alprazolam|05/28/2015| 00009005503|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00009005503|CE:ALP-ALP|Alprazolam|05/28/2015| 00009005503|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00009005503|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00009005602|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00009005602|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00009005604|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00009005604|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00009005707|CE:ALP-ALP|Alprazolam|05/28/2015| 00009005707|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00009005707|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00009005707|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00009005907|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00009005907|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00009005907|CE:ALP-ALP|Alprazolam|05/28/2015| 00009005907|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00009006607|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00009006607|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00009006607|CE:ALP-ALP|Alprazolam|05/28/2015| 00009006607|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00009006807|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00009006807|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00009006807|CE:ALP-ALP|Alprazolam|05/28/2015| 00009006807|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00009007301|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00009007301|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00009009001|CE:ALP-ALP|Alprazolam|05/28/2015| 00009009001|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00009009001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00009009001|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00009009004|CE:ALP-ALP|Alprazolam|05/28/2015| 00009009004|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00009009004|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00009009004|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00009009401|CE:ALP-ALP|Alprazolam|05/28/2015| 00009009401|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00009009401|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00009009401|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00009017601|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00009017601|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00009027101|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00009519001|CE:DRO-TOLTLA2|Drug Regimen Optimization|01/31/2011| 00009519002|CE:DRO-TOLTLA2|Drug Regimen Optimization|01/31/2011| 00009519003|CE:DRO-TOLTLA2|Drug Regimen Optimization|01/31/2011| 00013215036|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00013262681|CE:GRH-NPGROWTH|Growth Hormones|01/31/2011| 00013264681|CE:GRH-NPGROWTH|Growth Hormones|01/31/2011| 00013264902|CE:GRH-NPGROWTH|Growth Hormones|01/31/2011| 00013265002|CE:GRH-NPGROWTH|Growth Hormones|01/31/2011| 00013265102|CE:GRH-NPGROWTH|Growth Hormones|01/31/2011| 00013265202|CE:GRH-NPGROWTH|Growth Hormones|01/31/2011| 00013265302|CE:GRH-NPGROWTH|Growth Hormones|01/31/2011| 00013265402|CE:GRH-NPGROWTH|Growth Hormones|01/31/2011| 00013265502|CE:GRH-NPGROWTH|Growth Hormones|01/31/2011| 00013265602|CE:GRH-NPGROWTH|Growth Hormones|01/31/2011| 00013265702|CE:GRH-NPGROWTH|Growth Hormones|01/31/2011| 00013265802|CE:GRH-NPGROWTH|Growth Hormones|01/31/2011| 00023350730|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00023601460|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00023601460|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00023601460|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00023601460|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00023601560|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00023601560|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00023601560|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00023601560|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00023601960|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00023601960|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00023601960|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00023601960|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00023602205|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00023602205|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00023602205|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00023602205|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00024540131|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00024542131|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00024550131|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00024552131|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00024574502|CE:GLP-GLP|GLP-1 Receptor Agonists|09/25/2018| 00024574502|CE:DPP-SAX5|DPP-4 Inhibitors|09/25/2018| 00024574702|CE:GLP-GLP|GLP-1 Receptor Agonists|09/25/2018| 00024574702|CE:DPP-SAX5|DPP-4 Inhibitors|09/25/2018| 00024576105|CE:GLP-GLP|GLP-1 Receptor Agonists|09/25/2018| 00024576105|CE:DPP-SAX5|DPP-4 Inhibitors|09/25/2018| 00024585090|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00024585090|CE:DRO-IRBE75|Drug Regimen Optimization|01/31/2011| 00024585130|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00024585130|CE:DRO-IRBE150|Drug Regimen Optimization|01/31/2011| 00024585230|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00024585530|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00024585530|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00024585630|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00024585630|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00024590102|CE:PCS-PRA|PCSK9 Inhibitors|01/04/2017| 00024590202|CE:PCS-PRA|PCSK9 Inhibitors|01/04/2017| 00024590801|CE:CYC-KEVZ|Cytokine and CAM Antagonists|03/27/2018| 00024591001|CE:CYC-KEVZ|Cytokine and CAM Antagonists|03/27/2018| 00024591401|CE:DPX-DPX|Dupixent|10/31/2017| 00024591801|CE:DPX-DPX|Dupixent|10/31/2017| 00024592001|CE:CYC-KEVZ|Cytokine and CAM Antagonists|03/27/2018| 00024592201|CE:CYC-KEVZ|Cytokine and CAM Antagonists|03/27/2018| 00025101131|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00025102131|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00025138131|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00025141160|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00025141190|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00025142160|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00025151501|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 00025151501|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 00025152031|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 00025152031|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 00025152034|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 00025152034|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 00025152051|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 00025152051|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 00025152531|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 00025152531|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 00025152534|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 00025152534|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 00025152551|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 00025152551|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 00025153002|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 00025153002|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 00037200101|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00037200101|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00037200101|CE:CCA-LDCARIS|Carisoprodol Containing Agents|01/31/2011| 00037225010|CE:CCA-LDCARIS|Carisoprodol Containing Agents|01/31/2011| 00037225010|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00037225010|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00037601030|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00037605030|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00046074905|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00046087221|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00046110081|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00046110091|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00046110181|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00046110281|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00046110291|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00046110381|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00046110481|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00046110491|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00046110511|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00046110611|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00046110711|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00046110811|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00049005260|CE:APY-SGA|Antipsychotics|04/10/2016| 00049005460|CE:APY-SGA|Antipsychotics|04/10/2016| 00049005660|CE:APY-SGA|Antipsychotics|04/10/2016| 00049005860|CE:APY-SGA|Antipsychotics|04/10/2016| 00049017001|CE:DRO-GLIP2.5|Drug Regimen Optimization|01/31/2011| 00049275066|CE:DRO-DOXA1|Drug Regimen Optimization|01/31/2011| 00049276066|CE:DRO-DOXA2|Drug Regimen Optimization|01/31/2011| 00049277066|CE:DRO-DOXA4|Drug Regimen Optimization|01/31/2011| 00049392083|CE:APY-SGA|Antipsychotics|04/10/2016| 00049490030|CE:DRO-SRL50|Drug Regimen Optimization|01/31/2011| 00049490041|CE:DRO-SRL50|Drug Regimen Optimization|01/31/2011| 00049496030|CE:DRO-SRL25|Drug Regimen Optimization|01/31/2011| 00052010530|CE:DRO-MIRTZA15|Drug Regimen Optimization|01/31/2011|11/23/2020 00052010630|CE:DRO-MIRODT15|Drug Regimen Optimization|01/31/2011| 00052436401|CE:DRO-MIRTZA15|Drug Regimen Optimization|01/31/2011| 00054001720|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00054001720|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00054001725|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00054001725|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00054001729|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00054001729|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00054001820|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00054001820|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00054001825|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00054001825|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00054001829|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00054001829|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00054001920|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00054001920|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00054001925|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00054001925|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00054006344|CE:APY-ARI|Antipsychotics|04/10/2016| 00054008425|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00054008525|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00054008813|CE:FOS-FOSRENOL|Fosrenol (Lanthanum Carbonate)|01/31/2011| 00054008826|CE:FOS-FOSRENOL|Fosrenol (Lanthanum Carbonate)|01/31/2011| 00054012322|CE:DRO-LORSA25|Drug Regimen Optimization|01/31/2011| 00054012322|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00054014308|CE:AEM-ANTIEME|Antiemetics Oral|01/31/2011|08/31/2021 00054014387|CE:AEM-ANTIEME|Antiemetics Oral|01/31/2011|08/31/2021 00054017613|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054017613|CE:STX-STX|Subutex (buprenorphine)|12/05/2014| 00054017613|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054017713|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054017713|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054017713|CE:STX-STX|Subutex (buprenorphine)|12/05/2014| 00054018813|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054018813|CE:SUB-SUBOX|Suboxone|04/23/2013| 00054018813|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054018913|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054018913|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054018913|CE:SUB-SUBOX|Suboxone|04/23/2013| 00054022031|CE:APY-SGA|Antipsychotics|04/10/2016| 00054022125|CE:APY-SGA|Antipsychotics|04/10/2016| 00054022225|CE:APY-SGA|Antipsychotics|04/10/2016| 00054022321|CE:APY-SGA|Antipsychotics|04/10/2016| 00054022931|CE:APY-SGA|Antipsychotics|04/10/2016| 00054023025|CE:APY-SGA|Antipsychotics|04/10/2016| 00054023525|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054023525|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00054023525|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00054023525|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054023625|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00054023625|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00054023625|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054023625|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054023749|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00054023749|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054023749|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054023749|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00054023763|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054023763|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054023763|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00054023763|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00054023849|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054023849|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054023849|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00054023849|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00054023863|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054023863|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00054023863|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054023863|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00054024324|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00054024424|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054024424|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054024424|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00054024424|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00054024425|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054024425|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00054024425|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054024425|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00054024525|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054024525|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00054024525|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00054024525|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054025413|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00054025413|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00054025422|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00054025422|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00054025513|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00054025513|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00054025522|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00054025522|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00054026424|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054026424|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00054026424|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054026424|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00054026425|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00054026425|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00054026425|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054026425|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054026525|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054026525|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054026525|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00054026525|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00054028325|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054028325|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054028325|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00054028325|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00054028425|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054028425|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00054028425|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00054028425|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054028813|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015|06/30/2021 00054028822|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015|06/30/2021 00054028913|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015|06/30/2021 00054028922|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015|06/30/2021 00054029513|CE:GIM-ALO|GI Motility|01/18/2017| 00054029613|CE:GIM-ALO|GI Motility|01/18/2017| 00054038663|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054038663|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00054038663|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054038663|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00054038925|CE:ADD-IRMETHAM|ADD/ADHD Agents|02/13/2014| 00054039041|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054039041|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00054039041|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054039041|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00054039063|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00054039063|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054039063|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00054039063|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054039168|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054039168|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00054039168|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00054039168|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054039268|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054039268|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054039268|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00054039268|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00054040441|CE:OPO-OOVU|Opiate Overutilization|11/05/2013|10/31/2021 00054040441|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|10/31/2021 00054040441|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|10/31/2021 00054040441|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020|10/31/2021 00054040444|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|10/31/2021 00054040444|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020|10/31/2021 00054040444|CE:OPO-OOVU|Opiate Overutilization|11/05/2013|10/31/2021 00054040444|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|10/31/2021 00054040450|CE:OPO-OOVU|Opiate Overutilization|11/05/2013|10/31/2021 00054040450|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020|10/31/2021 00054040450|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|10/31/2021 00054040450|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|10/31/2021 00054046823|CE:VMAT-TET|VMAT2 Inhibitors|09/25/2018| 00054046923|CE:VMAT-TET|VMAT2 Inhibitors|09/25/2018| 00054051741|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054051741|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00054051741|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054051741|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00054051744|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054051744|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00054051744|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054051744|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00054051750|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00054051750|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054051750|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054051750|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00054054518|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00054054518|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00054054618|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00054054618|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00054054718|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00054054718|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00054055125|CE:OPO-OOVU|Opiate Overutilization|11/05/2013|02/28/2021 00054055125|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020|02/28/2021 00054055125|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|02/28/2021 00054055125|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|02/28/2021 00054055129|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|02/28/2021 00054055129|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|02/28/2021 00054055129|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020|02/28/2021 00054055129|CE:OPO-OOVU|Opiate Overutilization|11/05/2013|02/28/2021 00054306844|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054306844|CE:ALP-ALP|Alprazolam|05/28/2015| 00054306844|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054306844|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054309036|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054309036|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00054309036|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054309036|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00054317644|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00054317644|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00054317757|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00054317757|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00054317763|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00054317763|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00054318544|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054318544|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054318544|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054318544|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00054318863|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00054318863|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054318863|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054318863|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054353244|CE:ASH-LORAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00054353244|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054353244|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054353244|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054354563|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00054354563|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054354563|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00054354563|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054355344|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054355344|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00054355344|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054355344|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00054355563|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054355563|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00054355563|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054355563|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00054355663|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00054355663|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054355663|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00054355663|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054372144|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00054372144|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00054372250|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00054372250|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00054372263|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00054372263|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00054417925|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00054417925|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00054418025|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00054418025|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00054418125|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00054418125|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00054418225|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00054418225|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00054418325|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00054418325|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00054418425|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00054418425|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00054418625|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00054418625|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00054453825|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054453825|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054453825|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00054453825|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00054457025|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00054457025|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054457025|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00054457025|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054457125|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00054457125|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00054457125|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054457125|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054457125|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00054472825|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00054472825|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00054472831|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00054472831|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00054474125|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00054474125|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00054474131|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00054474131|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00054474225|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00054474225|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00054485825|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00054485825|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054485825|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054485825|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054485925|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054485925|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054485925|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00054485925|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054485929|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054485929|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00054485929|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054485929|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054817425|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00054817425|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00054817525|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00054817525|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00054817625|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00054817625|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00054817925|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00054817925|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00054818025|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00054818025|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00054818125|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00054818125|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00054818325|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00054818325|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00054855324|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00054855324|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00054855324|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054855324|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054855424|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00054855424|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054855424|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00054855424|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00054855424|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00054872425|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00054872425|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00054873925|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00054873925|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00054874025|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00054874025|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00056016970|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013|11/30/2020 00056017070|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013|10/31/2020 00056017275|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013|12/31/2020 00056017670|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013|10/31/2020 00056018870|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013|10/31/2020 00069019502|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00069019602|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00069020602|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00069021702|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00069022002|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00069022302|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00069022802|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00069023201|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00069033621|CE:SDF-REVSUSP|Sildenafil (Revatio)|09/01/2015| 00069033621|CE:SDF-REVATIO|Sildenafil (Revatio)|01/31/2011| 00069050130|CE:CYC-XELJ|Cytokine and CAM Antagonists|03/27/2018| 00069100101|CE:CYC-XELJ|Cytokine and CAM Antagonists|03/27/2018| 00069100201|CE:CYC-XELJ|Cytokine and CAM Antagonists|03/27/2018| 00069130501|CE:ESP-ESA|Erythropoiesis Stimulating Proteins|09/24/2013| 00069130510|CE:ESP-ESA|Erythropoiesis Stimulating Proteins|09/24/2013| 00069130601|CE:ESP-ESA|Erythropoiesis Stimulating Proteins|09/24/2013| 00069130610|CE:ESP-ESA|Erythropoiesis Stimulating Proteins|09/24/2013| 00069130701|CE:ESP-ESA|Erythropoiesis Stimulating Proteins|09/24/2013| 00069130710|CE:ESP-ESA|Erythropoiesis Stimulating Proteins|09/24/2013| 00069130801|CE:ESP-ESA|Erythropoiesis Stimulating Proteins|09/24/2013| 00069130810|CE:ESP-ESA|Erythropoiesis Stimulating Proteins|09/24/2013| 00069130901|CE:ESP-ESA|Erythropoiesis Stimulating Proteins|09/24/2013| 00069130904|CE:ESP-ESA|Erythropoiesis Stimulating Proteins|09/24/2013| 00069152068|CE:DRO-AMLOD2.5|Drug Regimen Optimization|01/31/2011| 00069153068|CE:DRO-AMLOD5|Drug Regimen Optimization|01/31/2011| 00069153072|CE:DRO-AMLOD5|Drug Regimen Optimization|01/31/2011| 00069215030|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 00069216030|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 00069217030|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 00069218030|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 00069219030|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 00069225030|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 00069226030|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 00069227030|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 00069265066|CE:DRO-NFP30|Drug Regimen Optimization|01/31/2011| 00069265072|CE:DRO-NFP30|Drug Regimen Optimization|01/31/2011| 00069322066|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00069323066|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00069419068|CE:SDF-REVATIO|Sildenafil (Revatio)|01/31/2011| 00069541066|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00069542066|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00071015523|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00071015523|CE:DRO-ATORV10|Drug Regimen Optimization|01/31/2011| 00071015623|CE:DRO-ATORV20|Drug Regimen Optimization|01/31/2011| 00071015623|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00071015723|CE:DRO-ATORV40|Drug Regimen Optimization|01/31/2011| 00071015723|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00071015823|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00071015873|CE:DUP-STN|Duplicate Therapy|02/04/2016|08/24/2021 00071022023|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00071022223|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00071022323|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00071040124|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 00071080324|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 00071080524|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 00071080624|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 00071201223|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011|01/22/2021 00071201244|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 00074006702|CE:CYC-HUMI|Cytokine and CAM Antagonists|03/27/2018| 00074012403|CE:CYC-HUMI|Cytokine and CAM Antagonists|03/27/2018| 00074024302|CE:CYC-HUMI|Cytokine and CAM Antagonists|03/27/2018| 00074055402|CE:CYC-HUMI|Cytokine and CAM Antagonists|03/27/2018| 00074061602|CE:CYC-HUMI|Cytokine and CAM Antagonists|03/27/2018| 00074081702|CE:CYC-HUMI|Cytokine and CAM Antagonists|03/27/2018| 00074153903|CE:CYC-HUMI|Cytokine and CAM Antagonists|03/27/2018| 00074204202|CE:CYC-SKY|Cytokine and CAM Antagonists|11/04/2019| 00074230630|CE:CYC-RIN|Cytokine and CAM Antagonists|03/03/2020| 00074254003|CE:CYC-HUMI|Cytokine and CAM Antagonists|03/27/2018| 00074262528|CE:HCA-HEPC|Hepatitis C Agents Clinical|01/23/2015| 00074309328|CE:HCA-HEPC|Hepatitis C Agents Clinical|01/23/2015| 00074326590|CE:DRO-NIASA500|Drug Regimen Optimization|01/31/2011| 00074379902|CE:CYC-HUMI|Cytokine and CAM Antagonists|03/27/2018| 00074382611|CE:DRO-DIVAL250|Drug Regimen Optimization|01/31/2011| 00074382613|CE:DRO-DIVAL250|Drug Regimen Optimization|01/31/2011| 00074433902|CE:CYC-HUMI|Cytokine and CAM Antagonists|03/27/2018| 00074433906|CE:CYC-HUMI|Cytokine and CAM Antagonists|03/27/2018| 00074433907|CE:CYC-HUMI|Cytokine and CAM Antagonists|03/27/2018| 00074634702|CE:CYC-HUMI|Cytokine and CAM Antagonists|03/27/2018| 00074937402|CE:CYC-HUMI|Cytokine and CAM Antagonists|03/27/2018| 00075062040|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00075062160|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00075062280|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00075062300|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00075062430|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00075062603|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00075291201|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00075291501|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00078031434|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00078031434|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00078031534|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00078031534|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00078034345|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00078034445|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00078034542|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00078034545|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00078034642|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00078034645|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00078035105|CE:DUP-MGL|Duplicate Therapy|02/05/2013| 00078035205|CE:DUP-MGL|Duplicate Therapy|02/05/2013| 00078035405|CE:DUP-STN|Duplicate Therapy|02/04/2016|02/28/2021 00078035415|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00078035834|CE:DRO-VALSA80|Drug Regimen Optimization|01/31/2011| 00078035834|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00078035934|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00078035934|CE:DRO-VALSA160|Drug Regimen Optimization|01/31/2011| 00078036034|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00078036542|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00078036545|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00078037005|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 00078037005|CE:DRO-MPHER20|Drug Regimen Optimization|01/31/2011| 00078037105|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 00078037205|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 00078038005|CE:ADD-IRFOC|ADD/ADHD Agents|02/13/2014| 00078038105|CE:ADD-IRFOC|ADD/ADHD Agents|02/13/2014| 00078038205|CE:ADD-IRFOC|ADD/ADHD Agents|02/13/2014| 00078038334|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00078038334|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00078042315|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00078042405|CE:DRO-MPHER10|Drug Regimen Optimization|01/31/2011| 00078042405|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 00078043005|CE:DRO-DMX5|Drug Regimen Optimization|01/31/2011| 00078043005|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 00078043105|CE:DRO-DMX10|Drug Regimen Optimization|01/31/2011| 00078043105|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 00078043205|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 00078043305|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 00078043405|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 00078043905|CE:ADD-IRMETHYL|ADD/ADHD Agents|02/13/2014| 00078044005|CE:ADD-IRMETHYL|ADD/ADHD Agents|02/13/2014| 00078044105|CE:ADD-IRMETHYL|ADD/ADHD Agents|02/13/2014| 00078047134|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00078047134|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00078047234|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00078047234|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00078048815|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00078048915|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00078049015|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00078049115|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00078049305|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 00078060805|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 00078060905|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 00078063941|CE:CYC-COSE|Cytokine and CAM Antagonists|03/27/2018| 00078063968|CE:CYC-COSE|Cytokine and CAM Antagonists|03/27/2018| 00078063997|CE:CYC-COSE|Cytokine and CAM Antagonists|03/27/2018| 00078063998|CE:CYC-COSE|Cytokine and CAM Antagonists|03/27/2018| 00078065920|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00078065967|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00078066419|CE:DUP-LABAC|Duplicate Therapy|02/04/2016| 00078069620|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00078069667|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00078073461|CE:CYC-ILAR|Cytokine and CAM Antagonists|03/27/2018| 00078077720|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00078077767|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00085113204|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 00085126401|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00085134101|CE:DUP-CRTROD|Duplicate Therapy|02/05/2013| 00085134102|CE:DUP-CRTROD|Duplicate Therapy|02/05/2013| 00085134107|CE:DUP-CRTROD|Duplicate Therapy|02/05/2013| 00085146102|CE:DUP-CRTROD|Duplicate Therapy|02/05/2013| 00085433301|CE:DUP-CRTROD|Duplicate Therapy|02/05/2013| 00085433401|CE:DUP-CRTROD|Duplicate Therapy|02/05/2013| 00085461001|CE:DUP-SALFL|Duplicate Therapy|02/05/2013| 00085720601|CE:DUP-SALFL|Duplicate Therapy|02/05/2013| 00093005001|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093005001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093005001|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00093005001|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00093005801|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093005801|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00093005801|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00093005801|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093005805|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00093005805|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093005805|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00093005805|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093007301|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00093007401|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00093015001|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00093015001|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093015001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093015001|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00093015010|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00093015010|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093015010|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00093015010|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093030801|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00093031401|CE:KET-KET|Ketorolac|05/25/2012| 00093031401|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00093035001|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093035001|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00093035001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093035001|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00093035005|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00093035005|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00093035005|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093035005|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093035010|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093035010|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00093035010|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093035010|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00093057610|CE:DRO-LOVA20|Drug Regimen Optimization|01/31/2011| 00093057610|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00093071101|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00093071105|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00093075501|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00093075505|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00093075506|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00093075601|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00093075701|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00093075705|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00093077198|CE:DRO-PRAVA10|Drug Regimen Optimization|01/31/2011| 00093077198|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00093083201|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011|03/31/2022 00093083201|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|03/31/2022 00093083201|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|03/31/2022 00093083201|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|03/31/2022 00093092401|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00093092405|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00093092606|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00093092606|CE:DRO-LOVA10|Drug Regimen Optimization|01/31/2011| 00093092610|CE:DRO-LOVA10|Drug Regimen Optimization|01/31/2011| 00093092610|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00093092810|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00093094801|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00093094805|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00093100501|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00093100505|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00093100601|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00093100605|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00093111801|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00093112201|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00093171201|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00093171210|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00093171301|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00093171310|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00093171401|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00093171410|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00093171501|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00093171601|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00093171610|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00093171801|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00093172001|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00093172101|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00093172110|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00093172301|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00093206301|CE:APY-SGA|Antipsychotics|04/10/2016| 00093206801|CE:DRO-DOXA4|Drug Regimen Optimization|01/31/2011| 00093206901|CE:DRO-DOXA2|Drug Regimen Optimization|01/31/2011| 00093207001|CE:DRO-DOXA1|Drug Regimen Optimization|01/31/2011| 00093308601|CE:APY-SGA|Antipsychotics|04/10/2016|07/30/2021 00093308684|CE:APY-SGA|Antipsychotics|04/10/2016| 00093308701|CE:APY-SGA|Antipsychotics|04/10/2016|07/30/2021 00093308784|CE:APY-SGA|Antipsychotics|04/10/2016|07/30/2021 00093309056|CE:MOD-ARM|Modafinil (Provigil)|02/06/2018| 00093309256|CE:MOD-ARM|Modafinil (Provigil)|02/06/2018| 00093309356|CE:MOD-ARM|Modafinil (Provigil)|02/06/2018| 00093309456|CE:MOD-ARM|Modafinil (Provigil)|02/06/2018| 00093312242|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00093312298|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00093313331|CE:IMI-IMIQ|Imiquimod|07/16/2012| 00093317431|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 00093321201|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00093321201|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093321201|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093321201|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093321305|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093321305|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093321305|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00093321305|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093322308|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00093322397|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00093322555|CE:DUP-NSD|Duplicate Therapy|02/05/2013|05/01/2021 00093323001|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 00093323001|CE:DRO-MPHER20|Drug Regimen Optimization|01/31/2011| 00093323101|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 00093323201|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 00093333406|CE:SDF-REVATIO|Sildenafil (Revatio)|01/31/2011| 00093354143|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00093354256|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 00093354356|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 00093354456|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 00093354556|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 00093354656|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 00093354756|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 00093354856|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 00093360782|CE:DUP-SALFL|Duplicate Therapy|02/05/2013| 00093360882|CE:DUP-SALFL|Duplicate Therapy|02/05/2013| 00093360982|CE:DUP-SALFL|Duplicate Therapy|02/05/2013| 00093365640|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00093365640|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093365640|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093365640|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00093365740|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00093365740|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093365740|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093365740|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00093365840|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093365840|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093365840|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00093365940|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093365940|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00093365940|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00093365940|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093372755|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00093414556|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 00093414656|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 00093414756|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 00093414856|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 00093435901|CE:APY-SGA|Antipsychotics|04/10/2016| 00093435905|CE:APY-SGA|Antipsychotics|04/10/2016| 00093435993|CE:APY-SGA|Antipsychotics|04/10/2016| 00093440401|CE:APY-SGA|Antipsychotics|04/10/2016| 00093440405|CE:APY-SGA|Antipsychotics|04/10/2016| 00093440505|CE:APY-SGA|Antipsychotics|04/10/2016| 00093440593|CE:APY-SGA|Antipsychotics|04/10/2016| 00093482210|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093482210|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093482210|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093482210|CE:ASH-LORAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00093500256|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00093500256|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00093500356|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00093500356|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00093500456|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00093500456|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00093500556|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00093500556|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00093500656|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00093500656|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00093504501|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 00093504601|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 00093505698|CE:DRO-ATORV10|Drug Regimen Optimization|01/31/2011| 00093505698|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00093505798|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00093505898|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00093505898|CE:DRO-ATORV40|Drug Regimen Optimization|01/31/2011| 00093505998|CE:DRO-ATORV20|Drug Regimen Optimization|01/31/2011| 00093505998|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00093506001|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00093506005|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00093506101|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00093506105|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00093506110|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00093506201|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00093506205|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00093524565|CE:APY-SGA|Antipsychotics|04/10/2016| 00093524565|CE:DRO-OLAODT5|Drug Regimen Optimization|01/31/2011| 00093524665|CE:DRO-OLAODT10|Drug Regimen Optimization|01/31/2011| 00093524665|CE:APY-SGA|Antipsychotics|04/10/2016| 00093524765|CE:APY-SGA|Antipsychotics|04/10/2016| 00093524865|CE:APY-SGA|Antipsychotics|04/10/2016| 00093529201|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 00093529301|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 00093529501|CE:DRO-MPHER10|Drug Regimen Optimization|01/31/2011| 00093529501|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 00093529601|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 00093529601|CE:DRO-MPHER20|Drug Regimen Optimization|01/31/2011| 00093529701|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 00093529801|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 00093534601|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 00093534601|CE:DRO-MPHER20|Drug Regimen Optimization|01/31/2011| 00093534701|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 00093534801|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 00093540189|CE:LVZ-LOVAZ|Lovaza|07/16/2012| 00093541601|CE:APY-SGA|Antipsychotics|04/10/2016| 00093541701|CE:APY-SGA|Antipsychotics|04/10/2016| 00093541784|CE:APY-SGA|Antipsychotics|04/10/2016| 00093541901|CE:APY-SGA|Antipsychotics|04/10/2016| 00093541984|CE:APY-SGA|Antipsychotics|04/10/2016| 00093545528|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00093545542|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00093550356|CE:APY-SGA|Antipsychotics|04/10/2016| 00093550456|CE:APY-SGA|Antipsychotics|04/10/2016| 00093550556|CE:APY-SGA|Antipsychotics|04/10/2016| 00093550656|CE:APY-SGA|Antipsychotics|04/10/2016| 00093550756|CE:APY-SGA|Antipsychotics|04/10/2016| 00093551798|CE:SDF-REVATIO|Sildenafil (Revatio)|01/31/2011| 00093553756|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00093553801|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00093553901|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00093555001|CE:DRO-DMX5|Drug Regimen Optimization|01/31/2011| 00093555001|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 00093555101|CE:DRO-DMX10|Drug Regimen Optimization|01/31/2011| 00093555101|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 00093555201|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 00093555301|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 00093555401|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 00093556201|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 00093573101|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00093573101|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093573101|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00093573101|CE:OXC-LD OXY|Oxycontin (Narcotic Analgesic)|01/31/2011| 00093573101|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093573201|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00093573201|CE:OXC-LD OXY|Oxycontin (Narcotic Analgesic)|01/31/2011| 00093573201|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00093573201|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093573201|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093573301|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093573301|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00093573301|CE:OXC-LD OXY|Oxycontin (Narcotic Analgesic)|01/31/2011| 00093573301|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093573301|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00093573401|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00093573401|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00093573401|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093573401|CE:OXC-HD OXY|Oxycontin (Narcotic Analgesic)|01/31/2011| 00093573401|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093585001|CE:DRO-ETP5|Drug Regimen Optimization|01/31/2011| 00093585005|CE:DRO-ETP5|Drug Regimen Optimization|01/31/2011| 00093585101|CE:DRO-ETP10|Drug Regimen Optimization|01/31/2011| 00093596001|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 00093596101|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 00093596301|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014|07/31/2021 00093596401|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014|05/31/2021 00093645056|CE:DRO-EMP20|Drug Regimen Optimization|01/31/2011| 00093645098|CE:DRO-EMP20|Drug Regimen Optimization|01/31/2011| 00093681573|CE:DUP-CRTROD|Duplicate Therapy|02/05/2013| 00093681673|CE:DUP-CRTROD|Duplicate Therapy|02/05/2013| 00093681773|CE:DUP-CRTROD|Duplicate Therapy|02/05/2013| 00093716305|CE:DRO-TOLTLA2|Drug Regimen Optimization|01/31/2011| 00093716356|CE:DRO-TOLTLA2|Drug Regimen Optimization|01/31/2011| 00093716398|CE:DRO-TOLTLA2|Drug Regimen Optimization|01/31/2011| 00093716501|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 00093716501|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 00093716505|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 00093716505|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 00093716601|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 00093716601|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 00093716605|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 00093716605|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 00093717006|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 00093717006|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 00093717201|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00093720110|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00093720110|CE:DRO-PRAVA20|Drug Regimen Optimization|01/31/2011| 00093720198|CE:DRO-PRAVA20|Drug Regimen Optimization|01/31/2011| 00093720198|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00093720210|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00093720210|CE:DRO-PRAVA40|Drug Regimen Optimization|01/31/2011| 00093720298|CE:DRO-PRAVA40|Drug Regimen Optimization|01/31/2011| 00093720298|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00093727010|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00093727098|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00093727105|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 00093727156|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 00093727198|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 00093727205|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 00093727256|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 00093727298|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 00093727305|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 00093727356|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 00093727398|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 00093729001|CE:DUP-RXF|Duplicate Therapy|02/04/2016| 00093729056|CE:DUP-RXF|Duplicate Therapy|02/04/2016| 00093730606|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 00093730606|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 00093735056|CE:DRO-LPZ15|Drug Regimen Optimization|01/31/2011| 00093736710|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00093736710|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00093736710|CE:DRO-LORS12.5|Drug Regimen Optimization|01/31/2011| 00093736756|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00093736756|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00093736756|CE:DRO-LORS12.5|Drug Regimen Optimization|01/31/2011| 00093736798|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00093736798|CE:DRO-LORS12.5|Drug Regimen Optimization|01/31/2011| 00093736798|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00093736810|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00093736810|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00093736856|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00093736856|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00093736898|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00093736898|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00093736910|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00093736910|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00093736956|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00093736956|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00093736998|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00093736998|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00093738001|CE:DRO-VENL37.5|Drug Regimen Optimization|01/31/2011|04/30/2021 00093738456|CE:DRO-VENL37.5|Drug Regimen Optimization|01/31/2011| 00093738498|CE:DRO-VENL37.5|Drug Regimen Optimization|01/31/2011| 00093738556|CE:DRO-VENL75|Drug Regimen Optimization|01/31/2011| 00093738598|CE:DRO-VENL75|Drug Regimen Optimization|01/31/2011| 00093739286|CE:DRO-NIASA500|Drug Regimen Optimization|01/31/2011| 00093742456|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015|05/31/2021 00093742498|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015|05/31/2021 00093742556|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015|05/31/2021 00093742598|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015|05/31/2021 00093742656|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015|04/30/2021 00093742698|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015|09/30/2021 00093744201|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00093744201|CE:DRO-FLUVA20|Drug Regimen Optimization|01/31/2011| 00093744256|CE:DRO-FLUVA20|Drug Regimen Optimization|01/31/2011| 00093744256|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00093744301|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00093744301|CE:DRO-FLUVA40|Drug Regimen Optimization|01/31/2011| 00093744356|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00093744356|CE:DRO-FLUVA40|Drug Regimen Optimization|01/31/2011| 00093744501|CE:DUP-OCS|Duplicate Therapy|02/04/2016|03/09/2021 00093744501|CE:DUP-OCRT|Duplicate Therapy|02/05/2013|03/09/2021 00093744601|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00093744656|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00093748756|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 00093761556|CE:DUP-ARB|Duplicate Therapy|02/05/2013|10/19/2021 00093761556|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013|10/19/2021 00093761656|CE:DUP-ARB|Duplicate Therapy|02/05/2013|10/19/2021 00093761656|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013|10/19/2021 00093761698|CE:DUP-ARB|Duplicate Therapy|02/05/2013|10/19/2021 00093761698|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013|10/19/2021 00093761756|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013|10/19/2021 00093761756|CE:DUP-ARB|Duplicate Therapy|02/05/2013|10/19/2021 00093770198|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00093777201|CE:APY-SGA|Antipsychotics|04/10/2016| 00093777205|CE:APY-SGA|Antipsychotics|04/10/2016| 00093777293|CE:APY-SGA|Antipsychotics|04/10/2016| 00093786565|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00093786565|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093786565|CE:ACT-ACTIQ200|Actiq Lozenges|01/31/2011| 00093786565|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093786565|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00093786665|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00093786665|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093786665|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093786665|CE:ACT-ACTIQ|Actiq Lozenges|01/31/2011| 00093786665|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00093786765|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00093786765|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093786765|CE:ACT-ACTIQ|Actiq Lozenges|01/31/2011| 00093786765|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00093786765|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093786865|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00093786865|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093786865|CE:ACT-ACTIQ|Actiq Lozenges|01/31/2011| 00093786865|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00093786865|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093786965|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093786965|CE:ACT-ACTIQ|Actiq Lozenges|01/31/2011| 00093786965|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093786965|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00093786965|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00093787065|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093787065|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00093787065|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00093787065|CE:ACT-ACTIQ|Actiq Lozenges|01/31/2011| 00093787065|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00093816201|CE:APY-SGA|Antipsychotics|04/10/2016| 00093816301|CE:APY-SGA|Antipsychotics|04/10/2016| 00093816401|CE:APY-SGA|Antipsychotics|04/10/2016| 00093816501|CE:APY-SGA|Antipsychotics|04/10/2016| 00093816601|CE:APY-SGA|Antipsychotics|04/10/2016| 00093823256|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00093823256|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00093823298|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00093823298|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00093823856|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00093823856|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00093823898|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00093823898|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00093914801|CE:DRO-VENL37.5|Drug Regimen Optimization|01/31/2011| 00113005705|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00113016626|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00113046162|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00113057826|CE:DXO-DEXQ|Dextromethorphan Overutilization|07/16/2012| 00113057826|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 00113060471|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00113060478|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00113060490|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00113061239|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00113061265|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00113066026|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00113089726|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00113089734|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00113091555|CE:DRO-OMP20|Drug Regimen Optimization|01/31/2011| 00115127701|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00115127701|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00115127701|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00115127701|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00115127801|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00115127801|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00115127801|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00115127801|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00115127901|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00115127901|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00115127901|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00115127901|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00115128001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00115128001|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00115128001|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00115128001|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00115128101|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00115128101|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00115128101|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00115128101|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00115128201|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00115128201|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00115128201|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00115128201|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00115143613|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00115143613|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011| 00115143613|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00115143713|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011| 00115143713|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00115143713|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00115147901|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00115147901|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00115147901|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00115147901|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00115148361|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00115148601|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 00115148601|CE:DRO-APHXL5|Drug Regimen Optimization|01/31/2011| 00115148701|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 00115148701|CE:DRO-APHXL10|Drug Regimen Optimization|01/31/2011| 00115148801|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 00115148801|CE:DRO-APHXK15|Drug Regimen Optimization|01/31/2011| 00115148901|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 00115149001|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 00115149101|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 00115151866|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00115155601|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00115155601|CE:OXC-LD OXY|Oxycontin (Narcotic Analgesic)|01/31/2011| 00115155601|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00115155601|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00115155601|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00115155701|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00115155701|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00115155701|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00115155701|CE:OXC-LD OXY|Oxycontin (Narcotic Analgesic)|01/31/2011| 00115155701|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00115155801|CE:OXC-LD OXY|Oxycontin (Narcotic Analgesic)|01/31/2011| 00115155801|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00115155801|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00115155801|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00115155801|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00115155901|CE:OXC-LD OXY|Oxycontin (Narcotic Analgesic)|01/31/2011| 00115155901|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00115155901|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00115155901|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00115155901|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00115156001|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00115156001|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00115156001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00115156001|CE:OXC-LD OXY|Oxycontin (Narcotic Analgesic)|01/31/2011| 00115156001|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00115156101|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00115156101|CE:OXC-HD OXY|Oxycontin (Narcotic Analgesic)|01/31/2011| 00115156101|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00115156101|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00115156101|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00115156201|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00115156201|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00115156201|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00115156201|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00115156201|CE:OXC-HD OXY|Oxycontin (Narcotic Analgesic)|01/31/2011| 00115165701|CE:DUP-NSD|Duplicate Therapy|02/05/2013|10/31/2020 00115165801|CE:DUP-NSD|Duplicate Therapy|02/05/2013|10/31/2020 00115168774|CE:DUP-CRTROD|Duplicate Therapy|02/05/2013| 00115168974|CE:DUP-CRTROD|Duplicate Therapy|02/05/2013| 00115169606|CE:DUP-OCS|Duplicate Therapy|02/04/2016|03/23/2021 00115169606|CE:DUP-OCRT|Duplicate Therapy|02/05/2013|03/23/2021 00115169701|CE:DUP-OCRT|Duplicate Therapy|02/05/2013|04/07/2021 00115169701|CE:DUP-OCS|Duplicate Therapy|02/04/2016|04/07/2021 00115170001|CE:DUP-OCS|Duplicate Therapy|02/04/2016|06/23/2021 00115170001|CE:DUP-OCRT|Duplicate Therapy|02/05/2013|06/23/2021 00115170901|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 00115171001|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 00115173601|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 00115173601|CE:DRO-MPHER10|Drug Regimen Optimization|01/31/2011| 00115173701|CE:DRO-MPHER20|Drug Regimen Optimization|01/31/2011| 00115173701|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 00115173801|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 00115173901|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 00115174001|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 00115174101|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 00115174501|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00115174501|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00115174801|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00115174801|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00115175701|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00115180001|CE:ADD-IRMETHYL|ADD/ADHD Agents|02/13/2014| 00115180101|CE:ADD-IRMETHYL|ADD/ADHD Agents|02/13/2014| 00115180201|CE:ADD-IRMETHYL|ADD/ADHD Agents|02/13/2014| 00115180301|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00115180302|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00115180401|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00115180402|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00115201101|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00115201101|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00115201102|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00115201102|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00115532201|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00115681108|CE:DRO-BUPR150|Drug Regimen Optimization|01/31/2011| 00115681110|CE:DRO-BUPR150|Drug Regimen Optimization|01/31/2011| 00115991801|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 00115991801|CE:DRO-DMX5|Drug Regimen Optimization|01/31/2011| 00115991901|CE:DRO-DMX10|Drug Regimen Optimization|01/31/2011| 00115991901|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 00115992001|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 00115992101|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 00115992201|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 00115992710|CE:ADD-ERDEX|ADD/ADHD Agents|02/13/2014| 00115992810|CE:ADD-ERDEX|ADD/ADHD Agents|02/13/2014| 00115992910|CE:ADD-ERDEX|ADD/ADHD Agents|02/13/2014| 00115993078|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 00115993178|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 00115993278|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 00121050404|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00121050404|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00121050404|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00121050416|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00121050416|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00121050416|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00121058104|CE:APY-FGA|Antipsychotics|04/10/2016| 00121065304|CE:APY-FGA|Antipsychotics|04/10/2016| 00121065402|CE:APY-FGA|Antipsychotics|04/10/2016| 00121075908|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00121075908|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00121077204|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00121077204|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00121077204|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00121077204|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00121077216|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00121077216|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00121077216|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00121077216|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00121077308|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00121077308|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00121077504|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 00121077504|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00121077504|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00121077504|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00121077508|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00121077508|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00121077508|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00121077508|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 00121077516|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00121077516|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 00121077516|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00121077516|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00121077708|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00121077708|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00143129005|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|06/30/2022 00143129005|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|06/30/2022 00143129201|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|06/30/2021 00143129201|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|06/30/2021 00143129205|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|07/31/2022 00143129205|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|07/31/2022 00143970001|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00143970001|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00168041630|CE:TIM-PRO|Topical Immunomodulators ( Elidel & Protopic)|01/31/2011| 00168041660|CE:TIM-PRO|Topical Immunomodulators ( Elidel & Protopic)|01/31/2011| 00168041699|CE:TIM-PRO|Topical Immunomodulators ( Elidel & Protopic)|01/31/2011| 00168041730|CE:TIM-TIM|Topical Immunomodulators ( Elidel & Protopic)|01/31/2011| 00168041760|CE:TIM-TIM|Topical Immunomodulators ( Elidel & Protopic)|01/31/2011| 00168041799|CE:TIM-TIM|Topical Immunomodulators ( Elidel & Protopic)|01/31/2011| 00168043224|CE:IMI-IMIQ5|Imiquimod|07/16/2012|11/30/2020 00168084401|CE:DUP-NSD|Duplicate Therapy|02/05/2013|11/23/2020 00169291115|CE:GLP-GLP|GLP-1 Receptor Agonists|09/25/2018| 00169291115|CE:DPP-SAX5|DPP-4 Inhibitors|09/25/2018| 00169406012|CE:DPP-SAX5|DPP-4 Inhibitors|09/25/2018| 00169406012|CE:GLP-GLP|GLP-1 Receptor Agonists|09/25/2018| 00169406013|CE:DPP-SAX5|DPP-4 Inhibitors|09/25/2018| 00169406013|CE:GLP-GLP|GLP-1 Receptor Agonists|09/25/2018| 00169413212|CE:GLP-GLP|GLP-1 Receptor Agonists|09/25/2018| 00169413212|CE:DPP-SAX5|DPP-4 Inhibitors|09/25/2018| 00169413602|CE:GLP-GLP|GLP-1 Receptor Agonists|09/25/2018| 00169413602|CE:DPP-SAX5|DPP-4 Inhibitors|09/25/2018| 00169430313|CE:GLP-GLP|GLP-1 Receptor Agonists|09/25/2018| 00169430713|CE:GLP-GLP|GLP-1 Receptor Agonists|09/25/2018| 00169431413|CE:GLP-GLP|GLP-1 Receptor Agonists|09/25/2018| 00169517603|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00169517604|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00169770321|CE:GRH-NPGROWTH|Growth Hormones|01/31/2011| 00169770421|CE:GRH-NPGROWTH|Growth Hormones|01/31/2011| 00169770521|CE:GRH-NPGROWTH|Growth Hormones|01/31/2011| 00169770821|CE:GRH-NPGROWTH|Growth Hormones|01/31/2011| 00172208360|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00172208380|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00172208960|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00172208980|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00172392560|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00172392560|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00172392560|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00172392560|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00172392570|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00172392570|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00172392570|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00172392570|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00172392660|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00172392660|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00172392660|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00172392660|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00172392670|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00172392670|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00172392670|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00172392670|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00172392680|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00172392680|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00172392680|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00172392680|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00172392760|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00172392760|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00172392760|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00172392760|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00172392770|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00172392770|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00172392770|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00172392770|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00172392780|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00172392780|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00172392780|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00172392780|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00173052100|CE:DUP-LABA|Duplicate Therapy|02/04/2016| 00173060002|CE:DUP-CRTROD|Duplicate Therapy|02/05/2013| 00173060102|CE:DUP-CRTROD|Duplicate Therapy|02/05/2013| 00173060202|CE:DUP-CRTROD|Duplicate Therapy|02/05/2013| 00173068220|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 00173068224|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 00173069500|CE:DUP-SALFL|Duplicate Therapy|02/05/2013| 00173069600|CE:DUP-SALFL|Duplicate Therapy|02/05/2013| 00173069700|CE:DUP-SALFL|Duplicate Therapy|02/05/2013| 00173071520|CE:DUP-SALFL|Duplicate Therapy|02/05/2013| 00173071522|CE:DUP-SALFL|Duplicate Therapy|02/05/2013| 00173071620|CE:DUP-SALFL|Duplicate Therapy|02/05/2013| 00173071622|CE:DUP-SALFL|Duplicate Therapy|02/05/2013| 00173071720|CE:DUP-SALFL|Duplicate Therapy|02/05/2013| 00173071722|CE:DUP-SALFL|Duplicate Therapy|02/05/2013| 00173071820|CE:DUP-CRTROD|Duplicate Therapy|02/05/2013| 00173071920|CE:DUP-CRTROD|Duplicate Therapy|02/05/2013| 00173072020|CE:DUP-CRTROD|Duplicate Therapy|02/05/2013| 00173085910|CE:DUP-SALFL|Duplicate Therapy|02/05/2013| 00173085914|CE:DUP-SALFL|Duplicate Therapy|02/05/2013| 00173086118|CE:TZD-ROSIGLIT|Hypoglycemics TZD|01/31/2011| 00173086313|CE:TZD-ROSIGLIT|Hypoglycemics TZD|01/31/2011| 00173086910|CE:DUP-LABAC|Duplicate Therapy|02/04/2016| 00173087410|CE:DUP-CRTROD|Duplicate Therapy|02/05/2013| 00173087610|CE:DUP-CRTROD|Duplicate Therapy|02/05/2013| 00173088210|CE:DUP-SALFL|Duplicate Therapy|02/05/2013| 00173088408|CE:LVZ-LOVAZ|Lovaza|07/16/2012| 00173088710|CE:DUP-SALFL|Duplicate Therapy|02/05/2013| 00173088714|CE:DUP-SALFL|Duplicate Therapy|02/05/2013| 00173088810|CE:DUP-CRTROD|Duplicate Therapy|02/05/2013| 00185002201|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00185002201|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00185002210|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00185002210|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00185007210|CE:DUP-STN|Duplicate Therapy|02/04/2016|11/23/2020 00185007210|CE:DRO-LOVA20|Drug Regimen Optimization|01/31/2011|11/23/2020 00185014101|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00185021101|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00185023601|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00185027701|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00185032501|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00185044801|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00185044801|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00185061501|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00185061505|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00185067401|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00185067405|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00185067501|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00185067510|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00185068701|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00185083101|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 00185084201|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 00185085301|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 00185086401|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 00186037020|CE:DUP-SALFL|Duplicate Therapy|02/05/2013| 00186037220|CE:DUP-SALFL|Duplicate Therapy|02/05/2013| 00186038230|CE:DRO-EMP20|Drug Regimen Optimization|01/31/2011|02/01/2022 00186038290|CE:DRO-EMP20|Drug Regimen Optimization|01/31/2011| 00186091612|CE:DUP-CRTROD|Duplicate Therapy|02/05/2013| 00186091706|CE:DUP-CRTROD|Duplicate Therapy|02/05/2013| 00186198804|CE:DUP-CRTROD|Duplicate Therapy|02/05/2013| 00186198904|CE:DUP-CRTROD|Duplicate Therapy|02/05/2013| 00186199004|CE:DUP-CRTROD|Duplicate Therapy|02/05/2013| 00186502031|CE:DRO-EMP20|Drug Regimen Optimization|01/31/2011| 00186502054|CE:DRO-EMP20|Drug Regimen Optimization|01/31/2011| 00187000402|CE:CYC-SILI|Cytokine and CAM Antagonists|03/27/2018| 00187014601|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00187065820|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00187065920|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00187073030|CE:DRO-BUPR150|Drug Regimen Optimization|01/31/2011| 00187073090|CE:DRO-BUPR150|Drug Regimen Optimization|01/31/2011| 00187510001|CE:TIM-TIM|Topical Immunomodulators ( Elidel & Protopic)|01/31/2011| 00187510102|CE:TIM-TIM|Topical Immunomodulators ( Elidel & Protopic)|01/31/2011| 00187510203|CE:TIM-TIM|Topical Immunomodulators ( Elidel & Protopic)|01/31/2011| 00228202710|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228202710|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228202710|CE:ALP-ALP|Alprazolam|05/28/2015| 00228202710|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228202750|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228202750|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228202750|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228202750|CE:ALP-ALP|Alprazolam|05/28/2015| 00228202796|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228202796|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228202796|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228202796|CE:ALP-ALP|Alprazolam|05/28/2015| 00228202910|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228202910|CE:ALP-ALP|Alprazolam|05/28/2015| 00228202910|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228202910|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228202950|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228202950|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228202950|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228202950|CE:ALP-ALP|Alprazolam|05/28/2015| 00228202996|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228202996|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228202996|CE:ALP-ALP|Alprazolam|05/28/2015| 00228202996|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228203110|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228203110|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228203110|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228203110|CE:ALP-ALP|Alprazolam|05/28/2015| 00228203150|CE:ALP-ALP|Alprazolam|05/28/2015| 00228203150|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228203150|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228203150|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228203196|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228203196|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228203196|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228203196|CE:ALP-ALP|Alprazolam|05/28/2015| 00228203910|CE:ALP-ALP|Alprazolam|05/28/2015| 00228203910|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228203910|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228203910|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228206710|CE:ASH-CMOXAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00228206710|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228206710|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228206710|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228206910|CE:ASH-CMOXAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00228206910|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228206910|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228206910|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228207310|CE:ASH-CMOXAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00228207310|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228207310|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228207310|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228207610|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228207610|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228207610|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228207610|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00228207650|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00228207650|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228207650|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228207650|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228207710|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00228207710|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228207710|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228207710|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228207750|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228207750|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228207750|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00228207750|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228234810|CE:PTU-PTU|Propylthiouracil|04/18/2011| 00228255006|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00228255011|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00228255096|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00228255106|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00228255111|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00228255196|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00228263611|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 00228263650|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 00228263711|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 00228263750|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 00228282011|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00228285011|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 00228285111|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 00228285311|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 00228285511|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 00228287811|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|03/23/2021 00228287811|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020|03/23/2021 00228287811|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|03/23/2021 00228287811|CE:OPO-OOVU|Opiate Overutilization|11/05/2013|03/23/2021 00228287911|CE:OPO-OOVU|Opiate Overutilization|11/05/2013|02/28/2021 00228287911|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020|02/28/2021 00228287911|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|02/28/2021 00228287911|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|02/28/2021 00228300511|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|04/09/2021 00228300511|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011|04/09/2021 00228300511|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|04/09/2021 00228300511|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|04/09/2021 00228305911|CE:DRO-APHXL10|Drug Regimen Optimization|01/31/2011| 00228305911|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 00228306011|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 00228306111|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 00228306211|CE:DRO-APHXL5|Drug Regimen Optimization|01/31/2011| 00228306211|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 00228306311|CE:DRO-APHXK15|Drug Regimen Optimization|01/31/2011| 00228306311|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 00228306411|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 00228308306|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228308306|CE:ALP-ALP|Alprazolam|05/28/2015| 00228308306|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228308306|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228308406|CE:ALP-ALP|Alprazolam|05/28/2015| 00228308406|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228308406|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228308406|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228308606|CE:ALP-ALP|Alprazolam|05/28/2015| 00228308606|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228308606|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228308606|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228308706|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228308706|CE:ALP-ALP|Alprazolam|05/28/2015| 00228308706|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228308706|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228309011|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228309011|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00228309011|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00228309011|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228309111|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228309111|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228309111|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00228309111|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00228309211|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00228309211|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00228309211|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228309211|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228309311|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00228309311|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228309311|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00228309311|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228311611|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228311611|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00228311611|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228311611|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00228311711|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00228311711|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228311711|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228311711|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00228315303|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228315303|CE:STX-STX|Subutex (buprenorphine)|12/05/2014| 00228315303|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228315403|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228315403|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228315403|CE:SUB-SUBOX|Suboxone|04/23/2013| 00228315473|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|02/13/2021 00228315473|CE:SUB-SUBOX|Suboxone|04/23/2013|02/13/2021 00228315473|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|02/13/2021 00228315503|CE:SUB-SUBOX|Suboxone|04/23/2013| 00228315503|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228315503|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228315567|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228315567|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228315567|CE:SUB-SUBOX|Suboxone|04/23/2013| 00228315573|CE:SUB-SUBOX|Suboxone|04/23/2013|02/13/2021 00228315573|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|02/13/2021 00228315573|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|02/13/2021 00228315603|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228315603|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228315603|CE:STX-STX|Subutex (buprenorphine)|12/05/2014| 00228350106|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228350106|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00228350106|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228350106|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00228350206|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00228350206|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00228350206|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228350206|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228350306|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228350306|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00228350306|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228350306|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00228350406|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228350406|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00228350406|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228350406|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00228350506|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228350506|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228350506|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00228350506|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00228350606|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00228350606|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228350606|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00228350606|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228350706|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00228350706|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00228350706|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228350706|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228401911|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228401911|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228401911|CE:ALP-ALP|Alprazolam|05/28/2015| 00228401911|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228402211|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228402211|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228402211|CE:ALP-ALP|Alprazolam|05/28/2015| 00228402211|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228402411|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228402411|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228402411|CE:ALP-ALP|Alprazolam|05/28/2015| 00228402411|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228402511|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228402511|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228402511|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228402511|CE:ALP-ALP|Alprazolam|05/28/2015| 00228402911|CE:OPO-OOVU|Opiate Overutilization|11/05/2013|04/30/2021 00228402911|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|04/30/2021 00228402911|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|04/30/2021 00228402911|CE:DUP-NSD|Duplicate Therapy|02/05/2013|04/30/2021 00228424106|CE:ADD-KAPVAY|ADD/ADHD Agents|02/13/2014| 00228427011|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228427011|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00228427011|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00228427011|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228427111|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00228427111|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228427111|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00228427111|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228431111|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228431111|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00228431111|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228431111|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00228432311|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228432311|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00228432311|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00228432311|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228434711|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00228434711|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00228434711|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00228434711|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00254100752|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 00254203601|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020|02/03/2021 00254203601|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|02/03/2021 00254203601|CE:OPO-OOVU|Opiate Overutilization|11/05/2013|02/03/2021 00254203601|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|02/03/2021 00254302002|CE:ENZ-NOR|Enzymes|11/20/2019| 00254302102|CE:ENZ-NOR|Enzymes|11/20/2019| 00254302202|CE:ENZ-NOR|Enzymes|11/20/2019| 00310027110|CE:APY-SGA|Antipsychotics|04/10/2016| 00310027210|CE:APY-SGA|Antipsychotics|04/10/2016| 00310027460|CE:APY-SGA|Antipsychotics|04/10/2016| 00310027510|CE:APY-SGA|Antipsychotics|04/10/2016| 00310027810|CE:APY-SGA|Antipsychotics|04/10/2016| 00310027910|CE:APY-SGA|Antipsychotics|04/10/2016| 00310028060|CE:APY-SGA|Antipsychotics|04/10/2016| 00310028160|CE:APY-SGA|Antipsychotics|04/10/2016| 00310028260|CE:APY-SGA|Antipsychotics|04/10/2016| 00310028360|CE:APY-SGA|Antipsychotics|04/10/2016| 00310028460|CE:APY-SGA|Antipsychotics|04/10/2016| 00310075190|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00310075190|CE:DRO-ROSUV10|Drug Regimen Optimization|01/31/2011| 00310075290|CE:DRO-ROSUV20|Drug Regimen Optimization|01/31/2011| 00310075290|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00310075430|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00310075590|CE:DRO-ROSUV5|Drug Regimen Optimization|01/31/2011| 00310075590|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00310196930|CE:GIM-MOV|GI Motility|01/18/2017|09/25/2021 00310197030|CE:GIM-MOV|GI Motility|01/18/2017|09/25/2021 00310460012|CE:DUP-LABAC|Duplicate Therapy|02/04/2016| 00310460039|CE:DUP-LABAC|Duplicate Therapy|02/04/2016| 00310610030|CE:DPP-SAX2|DPP-4 Inhibitors|09/25/2018| 00310610090|CE:DPP-SAX2|DPP-4 Inhibitors|09/25/2018| 00310610530|CE:DPP-SAX5|DPP-4 Inhibitors|09/25/2018| 00310610590|CE:DPP-SAX5|DPP-4 Inhibitors|09/25/2018| 00310612560|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 00310613530|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 00310614530|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 00310651201|CE:GLP-GLP|GLP-1 Receptor Agonists|09/25/2018| 00310651201|CE:DPP-SAX5|DPP-4 Inhibitors|09/25/2018| 00310652401|CE:DPP-SAX5|DPP-4 Inhibitors|09/25/2018| 00310652401|CE:GLP-GLP|GLP-1 Receptor Agonists|09/25/2018| 00310653004|CE:DPP-SAX5|DPP-4 Inhibitors|09/25/2018| 00310653004|CE:GLP-GLP|GLP-1 Receptor Agonists|09/25/2018| 00310654004|CE:GLP-GLP|GLP-1 Receptor Agonists|09/25/2018| 00310654004|CE:DPP-SAX5|DPP-4 Inhibitors|09/25/2018| 00310661502|CE:HIM-SYMLIN|Hypoglycemics Incretin Mimetics/Enhancers|01/31/2011| 00310662702|CE:HIM-SYMLIN|Hypoglycemics Incretin Mimetics/Enhancers|01/31/2011| 00310678030|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 00310737020|CE:DUP-SALFL|Duplicate Therapy|02/05/2013| 00310737220|CE:DUP-SALFL|Duplicate Therapy|02/05/2013| 00310828360|CE:APY-SGA|Antipsychotics|04/10/2016|12/01/2020 00310828460|CE:APY-SGA|Antipsychotics|04/10/2016|02/01/2021 00378003001|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378003001|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378003001|CE:ASH-CLORAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00378003001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378003005|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378003005|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378003005|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378003005|CE:ASH-CLORAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00378004001|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378004001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378004001|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378004001|CE:ASH-CLORAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00378004005|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378004005|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378004005|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378004005|CE:ASH-CLORAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00378004201|CE:APY-FGA|Antipsychotics|04/10/2016| 00378007001|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378007001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378007001|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378007001|CE:ASH-CLORAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00378007301|CE:APY-FGA|Antipsychotics|04/10/2016| 00378008101|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00378008301|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00378008401|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00378008601|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00378021401|CE:APY-FGA|Antipsychotics|04/10/2016| 00378021410|CE:APY-FGA|Antipsychotics|04/10/2016| 00378025701|CE:APY-FGA|Antipsychotics|04/10/2016| 00378025710|CE:APY-FGA|Antipsychotics|04/10/2016| 00378027101|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00378027101|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378027101|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378027101|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378027105|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378027105|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00378027105|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378027105|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378031301|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00378032701|CE:APY-FGA|Antipsychotics|04/10/2016| 00378032710|CE:APY-FGA|Antipsychotics|04/10/2016| 00378033001|CE:APY-FGA|Antipsychotics|04/10/2016| 00378033005|CE:APY-FGA|Antipsychotics|04/10/2016| 00378033401|CE:APY-FGA|Antipsychotics|04/10/2016| 00378033501|CE:APY-FGA|Antipsychotics|04/10/2016| 00378034501|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378034501|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378034501|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378034501|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00378034505|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378034505|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00378034505|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378034505|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378034701|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00378035101|CE:APY-FGA|Antipsychotics|04/10/2016| 00378035110|CE:APY-FGA|Antipsychotics|04/10/2016| 00378035301|CE:DRO-NFP30|Drug Regimen Optimization|01/31/2011| 00378040301|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00378042401|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00378042701|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00378043401|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00378044201|CE:APY-FGA|Antipsychotics|04/10/2016| 00378044205|CE:APY-FGA|Antipsychotics|04/10/2016| 00378044501|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00378046001|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00378046401|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00378047201|CE:DRO-DIVAL250|Drug Regimen Optimization|01/31/2011| 00378047205|CE:DRO-DIVAL250|Drug Regimen Optimization|01/31/2011| 00378047277|CE:DRO-DIVAL250|Drug Regimen Optimization|01/31/2011| 00378047701|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378047701|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378047701|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00378047701|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378047705|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378047705|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00378047705|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378047705|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378050701|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00378053101|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00378057401|CE:APY-FGA|Antipsychotics|04/10/2016| 00378057405|CE:APY-FGA|Antipsychotics|04/10/2016| 00378057701|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00378057705|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00378061201|CE:APY-FGA|Antipsychotics|04/10/2016| 00378061401|CE:APY-FGA|Antipsychotics|04/10/2016| 00378061601|CE:APY-FGA|Antipsychotics|04/10/2016| 00378061801|CE:APY-FGA|Antipsychotics|04/10/2016| 00378064001|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00378064001|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00378064010|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00378064010|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00378064101|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00378064101|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00378064110|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00378064110|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00378064201|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00378064201|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00378064205|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00378064205|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00378064210|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00378064210|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00378071101|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00378071201|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00378072301|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00378073101|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00378075101|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011| 00378075101|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378075101|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378075110|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011| 00378075110|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378075110|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378076101|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011| 00378076101|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378076101|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378077101|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378077101|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378077101|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011| 00378078191|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00378078293|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00378081001|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00378081005|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00378082501|CE:APY-SGA|Antipsychotics|04/10/2016| 00378086001|CE:APY-SGA|Antipsychotics|04/10/2016| 00378086005|CE:APY-SGA|Antipsychotics|04/10/2016| 00378092393|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378092393|CE:STX-STX|Subutex (buprenorphine)|12/05/2014| 00378092393|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378092493|CE:STX-STX|Subutex (buprenorphine)|12/05/2014| 00378092493|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378092493|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378097201|CE:APY-SGA|Antipsychotics|04/10/2016| 00378097301|CE:APY-SGA|Antipsychotics|04/10/2016| 00378100101|CE:APY-FGA|Antipsychotics|04/10/2016| 00378107593|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00378107693|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00378107793|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00378107893|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00378113401|CE:KET-KET|Ketorolac|05/25/2012| 00378113401|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00378135201|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00378135205|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00378135501|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00378135505|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00378145201|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00378145205|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00378145401|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00378145405|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00378145801|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00378145805|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00378145877|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00378165777|CE:SDF-REVATIO|Sildenafil (Revatio)|01/31/2011| 00378172193|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00378172293|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00378172393|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00378172493|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00378200201|CE:APY-FGA|Antipsychotics|04/10/2016| 00378200393|CE:DRO-PRX12.5|Drug Regimen Optimization|01/31/2011| 00378215001|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00378226001|CE:DRO-TERAZO1|Drug Regimen Optimization|01/31/2011| 00378226801|CE:DRO-TERAZO5|Drug Regimen Optimization|01/31/2011| 00378235093|CE:DRO-EMP20|Drug Regimen Optimization|01/31/2011| 00378240101|CE:APY-FGA|Antipsychotics|04/10/2016| 00378240201|CE:APY-FGA|Antipsychotics|04/10/2016| 00378240501|CE:APY-FGA|Antipsychotics|04/10/2016| 00378241001|CE:APY-FGA|Antipsychotics|04/10/2016| 00378247401|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00378253701|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00378253710|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00378292093|CE:DRO-TELMI20|Drug Regimen Optimization|01/31/2011| 00378292093|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00378300001|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00378300177|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00378300177|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00378300205|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00378300205|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00378300277|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00378300277|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00378300377|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00378300377|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00378300501|CE:APY-FGA|Antipsychotics|04/10/2016| 00378311001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378311001|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00378311001|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378311001|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378322477|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00378322477|CE:DRO-CARD4|Drug Regimen Optimization|01/31/2011| 00378322493|CE:DRO-CARD4|Drug Regimen Optimization|01/31/2011| 00378322493|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00378322577|CE:DRO-CARD8|Drug Regimen Optimization|01/31/2011| 00378322577|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00378322593|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00378322593|CE:DRO-CARD8|Drug Regimen Optimization|01/31/2011| 00378323177|CE:DRO-CARD16|Drug Regimen Optimization|01/31/2011| 00378323177|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00378323193|CE:DRO-CARD16|Drug Regimen Optimization|01/31/2011| 00378323193|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00378323277|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00378323293|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00378334999|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00378335099|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00378335199|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00378335299|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00378336099|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00378336199|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00378343193|CE:MOD-ARM|Modafinil (Provigil)|02/06/2018| 00378343293|CE:MOD-ARM|Modafinil (Provigil)|02/06/2018| 00378343393|CE:MOD-ARM|Modafinil (Provigil)|02/06/2018| 00378351501|CE:DRO-MIRTZA15|Drug Regimen Optimization|01/31/2011| 00378351593|CE:DRO-MIRTZA15|Drug Regimen Optimization|01/31/2011| 00378363501|CE:DRO-CERTIR5|Drug Regimen Optimization|01/31/2011| 00378363501|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00378363701|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00378363705|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00378395005|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00378395005|CE:DRO-ATORV10|Drug Regimen Optimization|01/31/2011| 00378395077|CE:DRO-ATORV10|Drug Regimen Optimization|01/31/2011| 00378395077|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00378395105|CE:DRO-ATORV20|Drug Regimen Optimization|01/31/2011| 00378395105|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00378395177|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00378395177|CE:DRO-ATORV20|Drug Regimen Optimization|01/31/2011| 00378395205|CE:DRO-ATORV40|Drug Regimen Optimization|01/31/2011| 00378395205|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00378395277|CE:DRO-ATORV40|Drug Regimen Optimization|01/31/2011| 00378395277|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00378395305|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00378395377|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00378397893|CE:APY-SGA|Antipsychotics|04/10/2016| 00378397993|CE:APY-SGA|Antipsychotics|04/10/2016| 00378398093|CE:APY-SGA|Antipsychotics|04/10/2016| 00378398193|CE:APY-SGA|Antipsychotics|04/10/2016| 00378400105|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378400105|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378400105|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378400105|CE:ALP-ALP|Alprazolam|05/28/2015| 00378400305|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378400305|CE:ALP-ALP|Alprazolam|05/28/2015| 00378400305|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378400305|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378400505|CE:ALP-ALP|Alprazolam|05/28/2015| 00378400505|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378400505|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378400505|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378400701|CE:ALP-ALP|Alprazolam|05/28/2015| 00378400701|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378400701|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378400701|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378401001|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00378401001|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378401001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378401001|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378401005|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00378401005|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378401005|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378401005|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378401077|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00378401077|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378401077|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378401077|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378402101|CE:DRO-DOXA1|Drug Regimen Optimization|01/31/2011| 00378402201|CE:DRO-DOXA2|Drug Regimen Optimization|01/31/2011| 00378402401|CE:DRO-DOXA4|Drug Regimen Optimization|01/31/2011| 00378408001|CE:DRO-DMX5|Drug Regimen Optimization|01/31/2011| 00378408001|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 00378408101|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 00378408101|CE:DRO-DMX10|Drug Regimen Optimization|01/31/2011| 00378408201|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 00378408301|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 00378408401|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 00378408501|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 00378415101|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00378415101|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378415101|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00378415101|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378415105|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00378415105|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378415105|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378415105|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00378415293|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378415293|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00378415293|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378415293|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00378415393|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378415393|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378415393|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00378415393|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00378441501|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378441501|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378441501|CE:ASH-FLURAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00378441501|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378443001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378443001|CE:ASH-FLURAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00378443001|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378443001|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378451493|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 00378451593|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 00378451793|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 00378451893|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 00378451993|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 00378461926|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00378462026|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00378462126|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00378462226|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00378462326|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00378464026|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00378464126|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00378464226|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00378464326|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00378464426|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00378471022|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00378471022|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00378471522|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00378471522|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00378472501|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00378473022|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00378473022|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00378473501|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00378474501|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00378477501|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00378501001|CE:APY-FGA|Antipsychotics|04/10/2016| 00378505001|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378505001|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378505001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378505001|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00378505005|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378505005|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378505005|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00378505005|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378505077|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378505077|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378505077|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378505077|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00378520001|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00378527001|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00378527101|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00378527201|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00378535001|CE:APY-FGA|Antipsychotics|04/10/2016| 00378535101|CE:APY-FGA|Antipsychotics|04/10/2016| 00378535201|CE:APY-FGA|Antipsychotics|04/10/2016| 00378535301|CE:APY-FGA|Antipsychotics|04/10/2016| 00378551093|CE:DRO-OLAODT5|Drug Regimen Optimization|01/31/2011| 00378551093|CE:APY-SGA|Antipsychotics|04/10/2016| 00378551193|CE:APY-SGA|Antipsychotics|04/10/2016| 00378551193|CE:DRO-OLAODT10|Drug Regimen Optimization|01/31/2011| 00378551293|CE:APY-SGA|Antipsychotics|04/10/2016| 00378551393|CE:APY-SGA|Antipsychotics|04/10/2016| 00378557305|CE:MOD-MOD|Modafinil (Provigil)|11/06/2012| 00378557305|CE:MOD-MOD|Modafinil (Provigil)|11/08/2012| 00378557393|CE:MOD-MOD|Modafinil (Provigil)|11/06/2012| 00378557393|CE:MOD-MOD|Modafinil (Provigil)|11/08/2012| 00378557505|CE:MOD-MOD|Modafinil (Provigil)|11/06/2012| 00378557505|CE:MOD-MOD|Modafinil (Provigil)|11/08/2012| 00378557593|CE:MOD-MOD|Modafinil (Provigil)|11/08/2012| 00378557593|CE:MOD-MOD|Modafinil (Provigil)|11/06/2012| 00378580793|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00378581377|CE:DRO-VALSA80|Drug Regimen Optimization|01/31/2011| 00378581377|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00378581477|CE:DRO-VALSA160|Drug Regimen Optimization|01/31/2011| 00378581477|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00378581577|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00378623101|CE:DRO-CTP10|Drug Regimen Optimization|01/31/2011| 00378623105|CE:DRO-CTP10|Drug Regimen Optimization|01/31/2011| 00378623201|CE:DRO-CTP20|Drug Regimen Optimization|01/31/2011| 00378623205|CE:DRO-CTP20|Drug Regimen Optimization|01/31/2011| 00378632105|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00378632105|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00378632177|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00378632177|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00378632277|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00378632277|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00378632305|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00378632305|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00378632377|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00378632377|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00378632477|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00378632477|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00378632505|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00378632505|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00378632577|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00378632577|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00378668877|CE:DRO-PNZ20|Drug Regimen Optimization|01/31/2011| 00378668899|CE:DRO-PNZ20|Drug Regimen Optimization|01/31/2011| 00378697193|CE:TDF-TDF|Tadalafil 5mg|11/04/2019| 00378697691|CE:SDF-REVATIO|Sildenafil (Revatio)|01/31/2011| 00378699152|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 00378699252|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 00378699393|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 00378700110|CE:DRO-PRX10|Drug Regimen Optimization|01/31/2011| 00378700193|CE:DRO-PRX10|Drug Regimen Optimization|01/31/2011| 00378700210|CE:DRO-PRX20|Drug Regimen Optimization|01/31/2011| 00378700293|CE:DRO-PRX20|Drug Regimen Optimization|01/31/2011| 00378700501|CE:APY-FGA|Antipsychotics|04/10/2016| 00378701001|CE:APY-FGA|Antipsychotics|04/10/2016| 00378701293|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00378702501|CE:APY-FGA|Antipsychotics|04/10/2016| 00378705001|CE:APY-FGA|Antipsychotics|04/10/2016| 00378711277|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00378711277|CE:DRO-OLMES20|Drug Regimen Optimization|01/31/2011| 00378711293|CE:DRO-OLMES20|Drug Regimen Optimization|01/31/2011| 00378711293|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00378712477|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00378712493|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00378715501|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00378715501|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00378729453|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00378729553|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00378801593|CE:DRO-LPZ15|Drug Regimen Optimization|01/31/2011| 00378802077|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00378802077|CE:DRO-FLUVA20|Drug Regimen Optimization|01/31/2011| 00378802093|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00378802093|CE:DRO-FLUVA20|Drug Regimen Optimization|01/31/2011| 00378802177|CE:DRO-FLUVA40|Drug Regimen Optimization|01/31/2011| 00378802177|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00378802193|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00378802193|CE:DRO-FLUVA40|Drug Regimen Optimization|01/31/2011| 00378808801|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378808801|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378808801|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00378808801|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00378808805|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00378808805|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00378808805|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378808805|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378815501|CE:DRO-MPHER18|Drug Regimen Optimization|01/31/2011| 00378815501|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 00378815601|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 00378815601|CE:DRO-MPHER27|Drug Regimen Optimization|01/31/2011| 00378815701|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 00378815801|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 00378820001|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00378827052|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 00378875006|CE:DUP-NSD|Duplicate Therapy|02/05/2013|09/30/2022 00378875559|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00378876516|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378876516|CE:SUB-SUBOX|Suboxone|04/23/2013| 00378876516|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378876593|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378876593|CE:SUB-SUBOX|Suboxone|04/23/2013| 00378876593|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378876616|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378876616|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378876616|CE:SUB-SUBOX|Suboxone|04/23/2013| 00378876693|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378876693|CE:SUB-SUBOX|Suboxone|04/23/2013| 00378876693|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378876716|CE:SUB-SUBOX|Suboxone|04/23/2013| 00378876716|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378876716|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378876793|CE:SUB-SUBOX|Suboxone|04/23/2013| 00378876793|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378876793|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378876816|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378876816|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378876816|CE:SUB-SUBOX|Suboxone|04/23/2013| 00378876893|CE:SUB-SUBOX|Suboxone|04/23/2013| 00378876893|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378876893|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378877035|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00378911998|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378911998|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00378911998|CE:DUR-DURAG|Duragesic (Fentanyl Transdermal)|01/31/2011| 00378911998|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00378911998|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378912198|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00378912198|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378912198|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00378912198|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378912198|CE:DUR-DURAG|Duragesic (Fentanyl Transdermal)|01/31/2011| 00378912298|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378912298|CE:DUR-DURAG|Duragesic (Fentanyl Transdermal)|01/31/2011| 00378912298|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378912298|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00378912298|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00378912398|CE:DUR-DURAG|Duragesic (Fentanyl Transdermal)|01/31/2011| 00378912398|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00378912398|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378912398|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378912398|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00378912498|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378912498|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378912498|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00378912498|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00378912498|CE:DUR-DURAG|Duragesic (Fentanyl Transdermal)|01/31/2011| 00378912598|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00378912598|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00378912598|CE:DUR-DURAG|Duragesic (Fentanyl Transdermal)|01/31/2011| 00378912598|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378912598|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378912698|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00378912698|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00378912698|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378912698|CE:DUR-DURAG|Duragesic (Fentanyl Transdermal)|01/31/2011| 00378912698|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378912798|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00378912798|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00378912798|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378912798|CE:DUR-DURAG|Duragesic (Fentanyl Transdermal)|01/31/2011| 00378912798|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378932032|CE:DUP-SALFL|Duplicate Therapy|02/05/2013| 00378932132|CE:DUP-SALFL|Duplicate Therapy|02/05/2013| 00378932232|CE:DUP-SALFL|Duplicate Therapy|02/05/2013| 00378963943|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378963943|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00378963943|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00378963943|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00378969052|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 00378969152|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 00378969252|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 00406012301|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406012301|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406012301|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406012301|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406012305|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406012305|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406012305|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406012305|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406012310|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406012310|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406012310|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406012310|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406012362|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406012362|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406012362|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406012362|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406012401|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406012401|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406012401|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406012401|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406012405|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406012405|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406012405|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406012405|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406012410|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406012410|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406012410|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406012410|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406012462|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406012462|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406012462|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406012462|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406012501|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406012501|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406012501|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406012501|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406012505|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406012505|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406012505|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406012505|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406012510|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406012510|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406012510|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406012510|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406012562|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406012562|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406012562|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406012562|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406012701|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 00406012701|CE:DRO-MPHER27|Drug Regimen Optimization|01/31/2011| 00406013601|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 00406015401|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 00406037601|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406037601|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406037601|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406037601|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406037605|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406037605|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406037605|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406037605|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406037701|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406037701|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406037701|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406037701|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406037705|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406037705|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406037705|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406037705|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406037801|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406037801|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406037801|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406037801|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406037805|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406037805|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406037805|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406037805|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406048301|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406048301|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406048301|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406048301|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406048401|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406048401|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406048401|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406048401|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406048410|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406048410|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406048410|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406048410|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406048462|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406048462|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406048462|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406048462|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406048501|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406048501|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406048501|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406048501|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406048505|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406048505|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406048505|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406048505|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406051201|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406051201|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406051201|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406051201|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406051205|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406051205|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406051205|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406051205|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406052201|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406052201|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406052201|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406052201|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406052205|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406052205|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406052205|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406052205|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406052301|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406052301|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406052301|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406052301|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406052305|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406052305|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406052305|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406052305|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406052710|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406052710|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406052710|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00406052710|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406054034|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406054034|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00406054034|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406054034|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406055201|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406055201|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406055201|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406055201|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406114201|CE:ADD-IRMETHYL|ADD/ADHD Agents|02/13/2014| 00406114401|CE:ADD-IRMETHYL|ADD/ADHD Agents|02/13/2014| 00406114601|CE:ADD-IRMETHYL|ADD/ADHD Agents|02/13/2014| 00406144501|CE:ADD-ERMETHYL|ADD/ADHD Agents|02/13/2014| 00406144501|CE:DRO-MPHTB10|Drug Regimen Optimization|01/31/2011| 00406147301|CE:ADD-ERMETHYL|ADD/ADHD Agents|02/13/2014| 00406181001|CE:DRO-MPHER10|Drug Regimen Optimization|01/31/2011| 00406181001|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 00406182001|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 00406182001|CE:DRO-MPHER20|Drug Regimen Optimization|01/31/2011| 00406183001|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 00406184001|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 00406185001|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 00406186001|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 00406192303|CE:SUB-SUBOX|Suboxone|04/23/2013| 00406192303|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406192303|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406254001|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406254001|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00406254001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406254001|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406324301|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406324301|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406324301|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406324301|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406324401|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406324401|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406324401|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406324401|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406324901|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406324901|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406324901|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406324901|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406575501|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406575501|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406575501|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406575501|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00406577101|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406577101|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00406577101|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406577101|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406577101|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406800312|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406800312|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406800312|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406800312|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406800315|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406800315|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406800315|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406800315|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406800324|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406800324|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406800324|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406800324|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406800330|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406800330|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406800330|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406800330|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406800503|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406800503|CE:SUB-SUBOX|Suboxone|04/23/2013| 00406800503|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406802003|CE:SUB-SUBOX|Suboxone|04/23/2013| 00406802003|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406802003|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406831501|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406831501|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406831501|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00406831501|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406832001|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00406832001|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406832001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406832001|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406833001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406833001|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406833001|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406833001|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00406838001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406838001|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406838001|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00406838001|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406839001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406839001|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406839001|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406839001|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00406851501|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406851501|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406851501|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406851501|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406851562|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406851562|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406851562|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406851562|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406853001|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406853001|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406853001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406853001|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406853062|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406853062|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406853062|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406853062|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406855605|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406855605|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406855605|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406855605|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406855730|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406855730|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406855730|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406872510|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406872510|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406872510|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406872510|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00406895801|CE:ADD-IRZen|ADD/ADHD Agents|02/13/2014| 00406895901|CE:ADD-IRZen|ADD/ADHD Agents|02/13/2014| 00406896001|CE:ADD-ERDEX|ADD/ADHD Agents|02/13/2014| 00406896101|CE:ADD-ERDEX|ADD/ADHD Agents|02/13/2014| 00406896201|CE:ADD-ERDEX|ADD/ADHD Agents|02/13/2014| 00406900076|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406900076|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406900076|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406900076|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00406900076|CE:DUR-DURAG|Duragesic (Fentanyl Transdermal)|01/31/2011| 00406901276|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00406901276|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406901276|CE:DUR-DURAG|Duragesic (Fentanyl Transdermal)|01/31/2011| 00406901276|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406901276|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406902576|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406902576|CE:DUR-DURAG|Duragesic (Fentanyl Transdermal)|01/31/2011| 00406902576|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00406902576|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406902576|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406905076|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406905076|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406905076|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00406905076|CE:DUR-DURAG|Duragesic (Fentanyl Transdermal)|01/31/2011| 00406905076|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406907576|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406907576|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00406907576|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406907576|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406907576|CE:DUR-DURAG|Duragesic (Fentanyl Transdermal)|01/31/2011| 00406920230|CE:ACT-ACTIQ200|Actiq Lozenges|01/31/2011| 00406920230|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406920230|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406920230|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406920230|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406920430|CE:ACT-ACTIQ|Actiq Lozenges|01/31/2011| 00406920430|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406920430|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406920430|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406920430|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406920630|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406920630|CE:ACT-ACTIQ|Actiq Lozenges|01/31/2011| 00406920630|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406920630|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406920630|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406920830|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406920830|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406920830|CE:ACT-ACTIQ|Actiq Lozenges|01/31/2011| 00406920830|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406920830|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406921230|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406921230|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406921230|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406921230|CE:ACT-ACTIQ|Actiq Lozenges|01/31/2011| 00406921230|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406921630|CE:ACT-ACTIQ|Actiq Lozenges|01/31/2011| 00406921630|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00406921630|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00406921630|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406921630|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406991403|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406991403|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406991403|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00406991403|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406991501|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406991501|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00406991501|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406991501|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406991503|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406991503|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406991503|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406991503|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00406991601|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00406991601|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406991601|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406991601|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406991701|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406991701|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406991701|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00406991701|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406995903|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406995903|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406995903|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406995903|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00406996001|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406996001|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406996001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00406996001|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00409113403|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00409113403|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00409113403|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00409113405|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00409113405|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00409113405|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00409118130|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00409118130|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00409118130|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00409118130|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00409120120|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00409120120|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00409120120|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00409120120|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00409120301|CE:OPO-OOVU|Opiate Overutilization|11/05/2013|01/01/2021 00409120301|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|01/01/2021 00409120301|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020|01/01/2021 00409120301|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|01/01/2021 00409125301|CE:OPO-OOVU|Opiate Overutilization|11/05/2013|11/23/2020 00409125301|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020|11/23/2020 00409125301|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|11/23/2020 00409125301|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|11/23/2020 00409125401|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|11/23/2020 00409125401|CE:OPO-OOVU|Opiate Overutilization|11/05/2013|11/23/2020 00409125401|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020|11/23/2020 00409125401|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|11/23/2020 00409125601|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|11/23/2020 00409125601|CE:OPO-OOVU|Opiate Overutilization|11/05/2013|11/23/2020 00409125601|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|11/23/2020 00409125601|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020|11/23/2020 00409146301|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00409146301|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00409146301|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00409146301|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00409146701|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00409146701|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00409146701|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00409146701|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00409189001|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00409189001|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00409189001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00409189101|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00409189101|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00409189101|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00409189201|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00409189201|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00409189201|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00409189301|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00409189301|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00409189301|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00409321312|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00409379601|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00409379601|CE:KET-KETINJ|Ketorolac|05/25/2012| 00409592201|CE:DUP-MLX|Duplicate Therapy|02/05/2013| 00409677802|CE:ASH-LORAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00409677802|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00409677802|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00409677802|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00409678002|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00409678002|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00409678002|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00409678002|CE:ASH-LORAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00430017015|CE:DRO-DARI7.5|Drug Regimen Optimization|01/31/2011|05/31/2021 00430072024|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00430072124|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00430072224|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00430375414|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00456120130|CE:GIM-LIN|GI Motility|01/18/2017| 00456120230|CE:GIM-LIN|GI Motility|01/18/2017| 00456120330|CE:GIM-LIN|GI Motility|01/18/2017| 00456200501|CE:DRO-ETP5|Drug Regimen Optimization|01/31/2011| 00456201001|CE:DRO-ETP10|Drug Regimen Optimization|01/31/2011| 00456240260|CE:APY-SGA|Antipsychotics|04/10/2016| 00456240560|CE:APY-SGA|Antipsychotics|04/10/2016| 00456240563|CE:APY-SGA|Antipsychotics|04/10/2016| 00456241060|CE:APY-SGA|Antipsychotics|04/10/2016| 00456241063|CE:APY-SGA|Antipsychotics|04/10/2016| 00456401001|CE:DRO-CTP10|Drug Regimen Optimization|01/31/2011| 00456402001|CE:DRO-CTP20|Drug Regimen Optimization|01/31/2011| 00472052794|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00472103016|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 00472103016|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00472103016|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00472103016|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00472176094|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00472176098|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00472176194|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00472176394|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00472176494|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00472178310|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00472200294|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00485008001|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 00485008001|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00485009816|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00485015516|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 00485015516|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00485017116|CE:DXO-DEXO|Dextromethorphan Overutilization|07/16/2012| 00485017116|CE:DXO-DEXN|Dextromethorphan Overutilization|07/16/2012| 00485017116|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00485017116|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 00485020216|CE:CCC-CCCA|Cough and Cold Agents - Clinical|12/15/2015| 00485020216|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00485020404|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00485020404|CE:DXO-DEXN|Dextromethorphan Overutilization|07/16/2012| 00485020404|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 00485020404|CE:DXO-DEXQCHLD|Dextromethorphan Overutilization|07/16/2012| 00485020416|CE:DXO-DEXN|Dextromethorphan Overutilization|07/16/2012| 00485020416|CE:DXO-DEXQCHLD|Dextromethorphan Overutilization|07/16/2012| 00485020416|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00485020416|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 00485020616|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00485020616|CE:CCC-CCCA|Cough and Cold Agents - Clinical|12/15/2015| 00485020816|CE:CCC-CCCA|Cough and Cold Agents - Clinical|12/15/2015| 00485024001|CE:DXO-DEXK|Dextromethorphan Overutilization|07/16/2012| 00485024001|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00485024001|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 00485024001|CE:DXO-DEXAA|Dextromethorphan Overutilization|07/16/2012| 00485025401|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 00485025401|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00487020101|CE:DUP-LABAC|Duplicate Therapy|02/04/2016| 00487020103|CE:DUP-LABAC|Duplicate Therapy|02/04/2016| 00487020160|CE:DUP-LABAC|Duplicate Therapy|02/04/2016| 00487030101|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 00487950101|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 00487950103|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 00487950125|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 00487950160|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 00487990130|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 00487990401|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 00487990425|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 00517042001|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00517044001|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00517176701|CE:MAK-MAK|Makena|06/12/2015| 00517420125|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00527131201|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00527131201|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00527131201|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00527131201|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00527135301|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00527135301|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00527135301|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00527135301|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00527135401|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00527135401|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00527135401|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00527135401|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00527135501|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00527135501|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00527135501|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00527135501|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00527139401|CE:APY-FGA|Antipsychotics|04/10/2016| 00527139501|CE:APY-FGA|Antipsychotics|04/10/2016| 00527139601|CE:APY-FGA|Antipsychotics|04/10/2016| 00527139701|CE:APY-FGA|Antipsychotics|04/10/2016| 00527143501|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00527143501|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00527150037|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 00527150137|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 00527150237|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 00527150337|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 00527150437|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 00527150537|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 00527150637|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 00527163201|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00527163210|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00527178801|CE:APY-FGA|Antipsychotics|04/10/2016| 00527178901|CE:APY-FGA|Antipsychotics|04/10/2016| 00527179001|CE:APY-FGA|Antipsychotics|04/10/2016| 00527179005|CE:APY-FGA|Antipsychotics|04/10/2016| 00527179101|CE:APY-FGA|Antipsychotics|04/10/2016| 00527179105|CE:APY-FGA|Antipsychotics|04/10/2016| 00527217037|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00527293037|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00527293037|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00527293043|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00527293043|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00527293137|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00527293137|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00527293237|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00527293237|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00527293243|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00527293243|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00527293337|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00527293337|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00527293341|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00527293341|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00527293437|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00527293437|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00527293441|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00527293441|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00527293537|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00527293537|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00527331037|CE:DRO-MPHER18|Drug Regimen Optimization|01/31/2011| 00527331037|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 00527331137|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 00527331137|CE:DRO-MPHER27|Drug Regimen Optimization|01/31/2011| 00527331237|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 00527331337|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 00527457937|CE:DRO-MPHER10|Drug Regimen Optimization|01/31/2011| 00527457937|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 00527458037|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 00527458037|CE:DRO-MPHER20|Drug Regimen Optimization|01/31/2011| 00527458137|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 00527458237|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 00527458337|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 00527458437|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 00527530264|CE:DXO-DEXQ|Dextromethorphan Overutilization|07/16/2012| 00527530264|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00527530264|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 00527530270|CE:DXO-DEXQ|Dextromethorphan Overutilization|07/16/2012| 00527530270|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00527530270|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 00527551037|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 00527551037|CE:DRO-APHXL5|Drug Regimen Optimization|01/31/2011| 00527551137|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 00527551137|CE:DRO-APHXL10|Drug Regimen Optimization|01/31/2011| 00527551237|CE:DRO-APHXK15|Drug Regimen Optimization|01/31/2011| 00527551237|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 00527551337|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 00527551437|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 00527551537|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 00527810637|CE:DRO-DMX5|Drug Regimen Optimization|01/31/2011| 00527810637|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 00527810737|CE:DRO-DMX10|Drug Regimen Optimization|01/31/2011| 00527810737|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 00527810837|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 00527810937|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 00527811037|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 00527811137|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 00527811237|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 00527811337|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 00536100601|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 00536100601|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00536100610|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00536100610|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 00536101001|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00536101801|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00536101810|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00536103413|CE:DRO-LPZ15|Drug Regimen Optimization|01/31/2011|01/31/2021 00536106834|CE:DXO-DEXBB|Dextromethorphan Overutilization|07/16/2012| 00536106834|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 00536108901|CE:DUP-NSD|Duplicate Therapy|02/05/2013|11/23/2020 00536109301|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00536109306|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00536109401|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00536114492|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013|07/31/2021 00536114730|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00536116134|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 00536116134|CE:DXO-DEXY|Dextromethorphan Overutilization|07/16/2012| 00536116134|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 00536116137|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 00536116137|CE:DXO-DEXY|Dextromethorphan Overutilization|07/16/2012| 00536116137|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 00536116361|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 00536116361|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 00536117801|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013|10/05/2021 00536117810|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00536118285|CE:CCC-CCCA|Cough and Cold Agents - Clinical|12/15/2015|04/22/2021 00536118297|CE:CCC-CCCA|Cough and Cold Agents - Clinical|12/15/2015| 00536118485|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015|08/27/2021 00536118485|CE:DXO-DEXQ|Dextromethorphan Overutilization|07/16/2012|08/27/2021 00536118497|CE:DXO-DEXQ|Dextromethorphan Overutilization|07/16/2012| 00536118497|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 00536120521|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 00536120521|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 00536120536|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 00536120536|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 00536121388|CE:DXO-DEXW|Dextromethorphan Overutilization|07/16/2012| 00536121388|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 00536121429|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00536123613|CE:DRO-LPZ15|Drug Regimen Optimization|01/31/2011| 00536123688|CE:DRO-LPZ15|Drug Regimen Optimization|01/31/2011| 00536124207|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00536125775|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00536125859|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00536129701|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00548560100|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00548560200|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00548560300|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00548560400|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00548560500|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00548560600|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00548560700|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00555003302|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00555003302|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00555003302|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00555003302|CE:ASH-CMOXAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00555003305|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00555003305|CE:ASH-CMOXAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00555003305|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00555003305|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00555009496|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00555009496|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00555009496|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00555009496|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00555009596|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00555009596|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00555009596|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00555009596|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00555009696|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00555009696|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00555009696|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00555009696|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00555009796|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00555009796|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00555009796|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00555009796|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00555009896|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00555009896|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00555009896|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00555009896|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00555015802|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00555015802|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00555015802|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00555015802|CE:ASH-CMOXAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00555015804|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00555015804|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00555015804|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00555015804|CE:ASH-CMOXAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00555015902|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00555015902|CE:ASH-CMOXAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00555015902|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00555015902|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00555015904|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00555015904|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00555015904|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00555015904|CE:ASH-CMOXAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00555030202|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00555030204|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00555032302|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00555032304|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00555032402|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00555048302|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00555048305|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00555077502|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 00555077602|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 00555077702|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 00555088602|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00555088604|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00555088702|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00555088704|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00555089902|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00555095202|CE:ADD-IRZen|ADD/ADHD Agents|02/13/2014| 00555095302|CE:ADD-IRZen|ADD/ADHD Agents|02/13/2014| 00555097102|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 00555097202|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 00555097302|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 00555097402|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 00574022701|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00574022801|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00574022901|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00574024001|CE:DUP-MGL|Duplicate Therapy|02/05/2013| 00574024101|CE:DUP-MGL|Duplicate Therapy|02/05/2013| 00574024201|CE:DUP-MGL|Duplicate Therapy|02/05/2013| 00574087005|CE:DUP-HRT|Duplicate Therapy|02/05/2013|02/28/2022 00574087205|CE:DUP-HRT|Duplicate Therapy|02/05/2013|01/31/2022 00574110404|CE:DXO-DEXQ|Dextromethorphan Overutilization|07/16/2012| 00574110404|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00574110404|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 00574110416|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00574110416|CE:DXO-DEXQ|Dextromethorphan Overutilization|07/16/2012| 00574110416|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 00574206727|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00574704012|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00574704012|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00574704012|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00574704012|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00574704512|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00574704512|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00574704512|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00574704512|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00574722406|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00574722406|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00574722406|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00574985010|CE:DUP-OCRT|Duplicate Therapy|02/05/2013|01/31/2022 00574985010|CE:DUP-OCS|Duplicate Therapy|02/04/2016|01/31/2022 00574985510|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00574985510|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00591024001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591024001|CE:ASH-LORAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00591024001|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591024001|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591024005|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591024005|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591024005|CE:ASH-LORAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00591024005|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591024010|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591024010|CE:ASH-LORAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00591024010|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591024010|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591024101|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591024101|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591024101|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591024101|CE:ASH-LORAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00591024105|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591024105|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591024105|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591024105|CE:ASH-LORAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00591024110|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591024110|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591024110|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591024110|CE:ASH-LORAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00591024201|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591024201|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591024201|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591024201|CE:ASH-LORAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00591024205|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591024205|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591024205|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591024205|CE:ASH-LORAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00591024210|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591024210|CE:ASH-LORAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00591024210|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591024210|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591034701|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00591034705|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00591034801|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00591034805|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00591034810|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00591036901|CE:APY-FGA|Antipsychotics|04/10/2016| 00591037001|CE:APY-FGA|Antipsychotics|04/10/2016| 00591037101|CE:APY-FGA|Antipsychotics|04/10/2016| 00591037201|CE:APY-FGA|Antipsychotics|04/10/2016| 00591039501|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591039501|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00591039501|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591039501|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00591039719|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00591039760|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00591039860|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00591042401|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00591042405|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00591074401|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00591074401|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591074401|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591074401|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591074501|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00591074501|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591074501|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591074501|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591079021|CE:DUP-OCRT|Duplicate Therapy|02/05/2013|11/02/2021 00591079021|CE:DUP-OCS|Duplicate Therapy|02/04/2016|11/02/2021 00591084401|CE:DRO-GLIP5|Drug Regimen Optimization|01/31/2011| 00591084410|CE:DRO-GLIP5|Drug Regimen Optimization|01/31/2011| 00591086001|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00591086005|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00591086101|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00591086105|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00591086201|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00591086205|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00591090030|CE:DRO-GLIP2.5|Drug Regimen Optimization|01/31/2011| 00591219101|CE:ASH-RAMELT|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00591219130|CE:ASH-RAMELT|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00591234101|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591234101|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591246401|CE:DES-DESMO|Desmopressin|05/25/2012| 00591246501|CE:DES-DESMO|Desmopressin|05/25/2012| 00591252001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591252001|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591252005|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591252005|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591264101|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591264101|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591264101|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00591269301|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591269301|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00591269301|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00591269301|CE:OXC-LD OXY|Oxycontin (Narcotic Analgesic)|01/31/2011| 00591269301|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591270801|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00591270801|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591270801|CE:OXC-HD OXY|Oxycontin (Narcotic Analgesic)|01/31/2011| 00591270801|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591270801|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00591292754|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 00591294430|CE:TIM-TIM|Topical Immunomodulators ( Elidel & Protopic)|01/31/2011| 00591294460|CE:TIM-TIM|Topical Immunomodulators ( Elidel & Protopic)|01/31/2011| 00591294487|CE:TIM-TIM|Topical Immunomodulators ( Elidel & Protopic)|01/31/2011| 00591299239|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011|05/11/2021 00591322001|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00591322001|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591322001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591322001|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00591325601|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591325601|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011| 00591325601|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591333001|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591333001|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011| 00591333001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591333105|CE:DRO-BUPR150|Drug Regimen Optimization|01/31/2011| 00591333119|CE:DRO-BUPR150|Drug Regimen Optimization|01/31/2011| 00591333130|CE:DRO-BUPR150|Drug Regimen Optimization|01/31/2011| 00591335401|CE:DUP-MGL|Duplicate Therapy|02/05/2013| 00591335501|CE:DUP-MGL|Duplicate Therapy|02/05/2013| 00591346753|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 00591346853|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 00591349901|CE:MOD-MOD|Modafinil (Provigil)|11/06/2012| 00591349901|CE:MOD-MOD|Modafinil (Provigil)|11/08/2012| 00591349930|CE:MOD-MOD|Modafinil (Provigil)|11/08/2012| 00591349930|CE:MOD-MOD|Modafinil (Provigil)|11/06/2012| 00591350001|CE:MOD-MOD|Modafinil (Provigil)|11/08/2012| 00591350001|CE:MOD-MOD|Modafinil (Provigil)|11/06/2012| 00591350030|CE:MOD-MOD|Modafinil (Provigil)|11/08/2012| 00591350030|CE:MOD-MOD|Modafinil (Provigil)|11/06/2012| 00591354601|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00591354601|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591354601|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00591354601|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591354605|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00591354605|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591354605|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00591354605|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591367001|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00591367005|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00591367101|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00591367105|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00591369230|CE:APY-SGA|Antipsychotics|04/10/2016| 00591369319|CE:APY-SGA|Antipsychotics|04/10/2016| 00591369330|CE:APY-SGA|Antipsychotics|04/10/2016| 00591369419|CE:APY-SGA|Antipsychotics|04/10/2016| 00591369430|CE:APY-SGA|Antipsychotics|04/10/2016| 00591369519|CE:APY-SGA|Antipsychotics|04/10/2016| 00591369530|CE:APY-SGA|Antipsychotics|04/10/2016| 00591379730|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 00591379760|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 00591379783|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 00591385419|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 00591386219|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 00591386919|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 00591387319|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 00591389119|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 00591389519|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 00591390219|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 00591398260|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 00591398260|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 00591398301|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 00591398301|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 00591398305|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 00591398305|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 00591398401|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 00591398401|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 00591398405|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 00591398405|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 00591410101|CE:APY-FGA|Antipsychotics|04/10/2016| 00591410201|CE:APY-FGA|Antipsychotics|04/10/2016| 00591410301|CE:APY-FGA|Antipsychotics|04/10/2016| 00591410401|CE:APY-FGA|Antipsychotics|04/10/2016| 00591437530|CE:DRO-DARI7.5|Drug Regimen Optimization|01/31/2011|05/31/2021 00591505201|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00591505201|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00591505210|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00591505210|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00591530701|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 00591530710|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 00591531901|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 00591544201|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00591544201|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00591544205|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00591544205|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00591544210|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00591544210|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00591544301|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00591544301|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00591544305|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00591544305|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00591544310|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00591544310|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00591551301|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591551301|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591551301|CE:CCA-LDCARIS|Carisoprodol Containing Agents|01/31/2011| 00591551305|CE:CCA-LDCARIS|Carisoprodol Containing Agents|01/31/2011| 00591551305|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591551305|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591551310|CE:CCA-LDCARIS|Carisoprodol Containing Agents|01/31/2011| 00591551310|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591551310|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591565801|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591565801|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591565801|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011| 00591565805|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591565805|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011| 00591565805|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591565810|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591565810|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011| 00591565810|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00591566001|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00591566005|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00591566101|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00591566105|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00591578201|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00591578301|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00591588201|CE:ADD-IRMETHYL|ADD/ADHD Agents|02/13/2014| 00591588301|CE:ADD-IRMETHYL|ADD/ADHD Agents|02/13/2014| 00591588401|CE:ADD-IRMETHYL|ADD/ADHD Agents|02/13/2014| 00597002402|CE:DUP-LABAC|Duplicate Therapy|02/04/2016| 00597002901|CE:COX-MOBIC|COX-2 Inhibitors|01/31/2011| 00597002901|CE:DRO-MELOX7.5|Drug Regimen Optimization|01/31/2011| 00597002901|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 00597003001|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 00597003001|CE:COX-MOBIC|COX-2 Inhibitors|01/31/2011| 00597003937|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00597003937|CE:DRO-TELMI20|Drug Regimen Optimization|01/31/2011| 00597004037|CE:DRO-TELMI40|Drug Regimen Optimization|01/31/2011| 00597004037|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00597004137|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00597004237|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00597004237|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00597004337|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00597004337|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00597004437|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00597004437|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00597014030|CE:DPP-LIN5|DPP-4 Inhibitors|09/25/2018| 00597014090|CE:DPP-LIN5|DPP-4 Inhibitors|09/25/2018| 00597014618|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 00597014660|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 00597014718|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 00597014760|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 00597014818|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 00597014860|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 00597015531|CE:DUP-LABAC|Duplicate Therapy|02/04/2016|07/31/2021 00597015561|CE:DUP-LABAC|Duplicate Therapy|02/04/2016| 00597015570|CE:DUP-LABAC|Duplicate Therapy|02/04/2016| 00597016430|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 00597016490|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 00597018230|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 00597018239|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 00597018290|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 00597019261|CE:DUP-LABA|Duplicate Therapy|02/04/2016| 00597027073|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 00597027094|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 00597027533|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 00597027581|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 00597035509|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00597035556|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00597036055|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00597036082|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00603233721|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00603233721|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00603233721|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00603233721|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00603233821|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00603233821|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00603233821|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00603233821|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00603233832|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00603233832|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00603233832|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00603233832|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00603233921|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00603233921|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00603233921|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00603233921|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00603233928|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00603233928|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00603233928|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00603233928|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00603255321|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00603255321|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00603255321|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00603255321|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00603358121|CE:DRO-FLP2.5|Drug Regimen Optimization|01/31/2011| 00603358128|CE:DRO-FLP2.5|Drug Regimen Optimization|01/31/2011| 00603358221|CE:DRO-FLP5|Drug Regimen Optimization|01/31/2011| 00603358228|CE:DRO-FLP5|Drug Regimen Optimization|01/31/2011| 00603358421|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00603358421|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00603358421|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00603358421|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00603358421|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00603358621|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00603358621|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00603358621|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00603358621|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00603358621|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00603388728|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00603388728|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00603388728|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00603388728|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00603388732|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00603388732|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00603388732|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00603388732|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00603389028|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00603389028|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00603389028|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00603389028|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00603389032|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00603389032|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00603389032|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00603389032|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00603389128|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00603389128|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00603389128|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00603389128|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00603389132|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00603389132|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00603389132|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00603389132|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00603389721|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00603389721|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00603389721|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00603389721|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00603389721|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00603389728|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00603389728|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00603389728|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00603389728|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00603389728|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00603459315|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00603459315|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00603459321|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00603459321|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00603497821|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00603497821|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00603497821|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00603497821|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00603497921|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00603497921|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00603497921|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00603497921|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00603497928|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00603497928|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00603497928|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00603497928|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00603498221|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00603498221|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00603498221|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00603498221|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00603498228|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00603498228|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00603498228|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00603498228|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00603499821|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00603499821|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00603499821|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00603499821|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00603499828|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00603499828|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00603499828|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00603499828|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00603506021|CE:APY-FGA|Antipsychotics|04/10/2016| 00603506121|CE:APY-FGA|Antipsychotics|04/10/2016| 00603506128|CE:APY-FGA|Antipsychotics|04/10/2016| 00603506221|CE:APY-FGA|Antipsychotics|04/10/2016| 00603506228|CE:APY-FGA|Antipsychotics|04/10/2016| 00603506321|CE:APY-FGA|Antipsychotics|04/10/2016| 00603533521|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00603533521|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00603533532|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00603533532|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00603533621|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00603533621|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00603533715|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00603533715|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00603533721|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00603533721|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00603533731|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00603533731|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00603533732|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00603533732|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00603533815|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00603533815|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00603533821|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00603533821|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00603533828|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00603533828|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00603533831|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00603533831|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00603533832|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00603533832|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00603533921|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00603533921|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00603533928|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00603533928|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00603533932|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00603533932|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00641092821|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 00641092825|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 00641092921|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 00641092925|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 00641094931|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 00641094935|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 00641149535|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 00641149635|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 00641605225|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00641605225|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00641605225|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00641605225|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00641605325|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00641605325|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00641605325|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00641605325|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00641605425|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00641605425|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00641605425|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00641605425|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00641608425|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 00703001801|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00703001801|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00703001801|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00703001801|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00703011003|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00703011003|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00703011003|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00703011003|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00703011303|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00703011303|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00703011303|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00703011303|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00703505103|CE:DES-DESMOINJ|Desmopressin|05/25/2012| 00703505401|CE:DES-DESMOINJ|Desmopressin|05/25/2012| 00703797103|CE:AEM-ANTIEME|Antiemetics Oral|01/31/2011| 00703797301|CE:AEM-ANTIEME|Antiemetics Oral|01/31/2011| 00703851021|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00703851023|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00703853023|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00703854023|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00703856023|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00703858021|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00703858023|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00703861023|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00703868023|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00713013212|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 00713052612|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 00713053612|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 00781106101|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781106101|CE:ALP-ALP|Alprazolam|05/28/2015| 00781106101|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781106101|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781106105|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781106105|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781106105|CE:ALP-ALP|Alprazolam|05/28/2015| 00781106105|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781106110|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781106110|CE:ALP-ALP|Alprazolam|05/28/2015| 00781106110|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781106110|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781107701|CE:ALP-ALP|Alprazolam|05/28/2015| 00781107701|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781107701|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781107701|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781107705|CE:ALP-ALP|Alprazolam|05/28/2015| 00781107705|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781107705|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781107705|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781107710|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781107710|CE:ALP-ALP|Alprazolam|05/28/2015| 00781107710|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781107710|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781107901|CE:ALP-ALP|Alprazolam|05/28/2015| 00781107901|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781107901|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781107901|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781107905|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781107905|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781107905|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781107905|CE:ALP-ALP|Alprazolam|05/28/2015| 00781107910|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781107910|CE:ALP-ALP|Alprazolam|05/28/2015| 00781107910|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781107910|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781108901|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781108901|CE:ALP-ALP|Alprazolam|05/28/2015| 00781108901|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781108901|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781108905|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781108905|CE:ALP-ALP|Alprazolam|05/28/2015| 00781108905|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781108905|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781183001|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 00781183010|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 00781183201|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 00781205101|CE:DRO-TERAZO1|Drug Regimen Optimization|01/31/2011|11/23/2020 00781205301|CE:DRO-TERAZO5|Drug Regimen Optimization|01/31/2011|11/23/2020 00781207401|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00781207410|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00781208102|CE:FOS-FOSRENOL|Fosrenol (Lanthanum Carbonate)|01/31/2011| 00781214710|CE:DRO-LPZ15|Drug Regimen Optimization|01/31/2011| 00781214731|CE:DRO-LPZ15|Drug Regimen Optimization|01/31/2011| 00781216460|CE:APY-SGA|Antipsychotics|04/10/2016| 00781216660|CE:APY-SGA|Antipsychotics|04/10/2016| 00781216760|CE:APY-SGA|Antipsychotics|04/10/2016| 00781216860|CE:APY-SGA|Antipsychotics|04/10/2016| 00781232106|CE:AEM-ANTIEME|Antiemetics Oral|01/31/2011| 00781232151|CE:AEM-ANTIEME|Antiemetics Oral|01/31/2011| 00781232246|CE:AEM-ANTIEME|Antiemetics Oral|01/31/2011| 00781232268|CE:AEM-ANTIEME|Antiemetics Oral|01/31/2011| 00781232368|CE:AEM-ANTIEME|Antiemetics Oral|01/31/2011| 00781232901|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 00781232901|CE:DRO-APHXL5|Drug Regimen Optimization|01/31/2011| 00781233501|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 00781233501|CE:DRO-APHXL10|Drug Regimen Optimization|01/31/2011| 00781234301|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 00781234301|CE:DRO-APHXK15|Drug Regimen Optimization|01/31/2011| 00781235201|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 00781236101|CE:DRO-MPHER10|Drug Regimen Optimization|01/31/2011| 00781236101|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 00781236201|CE:DRO-MPHER20|Drug Regimen Optimization|01/31/2011| 00781236201|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 00781236301|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 00781236401|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 00781236801|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 00781237101|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 00781268201|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 00781268201|CE:DRO-DMX5|Drug Regimen Optimization|01/31/2011| 00781268301|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 00781268301|CE:DRO-DMX10|Drug Regimen Optimization|01/31/2011| 00781268401|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 00781268501|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 00781268601|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 00781268701|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 00781268801|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 00781268901|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 00781286810|CE:DRO-OMP20|Drug Regimen Optimization|01/31/2011| 00781286831|CE:DRO-OMP20|Drug Regimen Optimization|01/31/2011| 00781286892|CE:DRO-OMP20|Drug Regimen Optimization|01/31/2011| 00781300107|CE:GRH-NPGROWTH|Growth Hormones|01/31/2011| 00781300407|CE:GRH-NPGROWTH|Growth Hormones|01/31/2011| 00781313363|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013|04/30/2021 00781315972|CE:APY-SGA|Antipsychotics|04/10/2016| 00781322464|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013|05/31/2021 00781335666|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013|02/28/2021 00781342868|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013|01/31/2021 00781350069|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013|01/31/2021 00781361268|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013|04/30/2021 00781365569|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013|02/28/2021 00781400436|CE:GRH-NPGROWTH|Growth Hormones|01/31/2011| 00781406336|CE:AEM-ANTIEME|Antiemetics Oral|01/31/2011| 00781502201|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00781502201|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00781502207|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 00781502207|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 00781527664|CE:DRO-DONEODT5|Drug Regimen Optimization|01/31/2011| 00781531501|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00781531601|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00781531701|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00781531710|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00781531801|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00781531810|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00781534201|CE:APY-SGA|Antipsychotics|04/10/2016| 00781534301|CE:APY-SGA|Antipsychotics|04/10/2016| 00781534401|CE:APY-SGA|Antipsychotics|04/10/2016| 00781534601|CE:APY-SGA|Antipsychotics|04/10/2016| 00781534701|CE:APY-SGA|Antipsychotics|04/10/2016| 00781534801|CE:APY-SGA|Antipsychotics|04/10/2016| 00781538192|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00781538192|CE:DRO-ATORV10|Drug Regimen Optimization|01/31/2011| 00781538292|CE:DRO-ATORV20|Drug Regimen Optimization|01/31/2011| 00781538292|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00781538492|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00781538492|CE:DRO-ATORV40|Drug Regimen Optimization|01/31/2011| 00781538892|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00781540092|CE:DRO-ROSUV5|Drug Regimen Optimization|01/31/2011| 00781540092|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00781540192|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00781540192|CE:DRO-ROSUV10|Drug Regimen Optimization|01/31/2011| 00781540292|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00781540292|CE:DRO-ROSUV20|Drug Regimen Optimization|01/31/2011| 00781540331|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00781542010|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 00781542031|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 00781542092|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 00781542110|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 00781542131|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 00781542192|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 00781542210|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 00781542231|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 00781542292|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 00781552810|CE:DRO-BUPR150|Drug Regimen Optimization|01/31/2011| 00781552831|CE:DRO-BUPR150|Drug Regimen Optimization|01/31/2011| 00781555431|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 00781555492|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 00781555531|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 00781555592|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 00781556701|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|11/30/2020 00781556701|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|11/30/2020 00781556701|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|11/30/2020 00781556701|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011|11/30/2020 00781556705|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|10/31/2020 00781556705|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011|10/31/2020 00781556705|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|10/31/2020 00781556705|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|10/31/2020 00781556710|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|11/30/2020 00781556710|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|11/30/2020 00781556710|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011|11/30/2020 00781556710|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|11/30/2020 00781562660|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011|11/30/2020 00781562760|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011|01/31/2021 00781564331|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00781570110|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00781570110|CE:DRO-LORSA50|Drug Regimen Optimization|01/31/2011| 00781591301|CE:APY-FGA|Antipsychotics|04/10/2016| 00781591401|CE:APY-FGA|Antipsychotics|04/10/2016| 00781591501|CE:APY-FGA|Antipsychotics|04/10/2016| 00781591601|CE:APY-FGA|Antipsychotics|04/10/2016| 00781591701|CE:APY-FGA|Antipsychotics|04/10/2016| 00781593631|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00781593631|CE:DRO-CARD4|Drug Regimen Optimization|01/31/2011| 00781593731|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00781593731|CE:DRO-CARD8|Drug Regimen Optimization|01/31/2011| 00781593831|CE:DRO-CARD16|Drug Regimen Optimization|01/31/2011| 00781593831|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00781593892|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00781593892|CE:DRO-CARD16|Drug Regimen Optimization|01/31/2011| 00781593931|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00781593992|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00781598901|CE:APY-SGA|Antipsychotics|04/10/2016|06/30/2021 00781599201|CE:APY-SGA|Antipsychotics|04/10/2016|06/30/2021 00781710454|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00781711954|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00781712254|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00781712983|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00781713354|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00781713454|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00781713654|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00781713883|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00781714483|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00781715683|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00781716783|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 00781721606|CE:SUB-SUBOX|Suboxone|04/23/2013| 00781721606|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781721606|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781721664|CE:SUB-SUBOX|Suboxone|04/23/2013| 00781721664|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781721664|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781722706|CE:SUB-SUBOX|Suboxone|04/23/2013| 00781722706|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781722706|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781722764|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781722764|CE:SUB-SUBOX|Suboxone|04/23/2013| 00781722764|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781723806|CE:SUB-SUBOX|Suboxone|04/23/2013| 00781723806|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781723806|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781723864|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781723864|CE:SUB-SUBOX|Suboxone|04/23/2013| 00781723864|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781724906|CE:SUB-SUBOX|Suboxone|04/23/2013| 00781724906|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781724906|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781724964|CE:SUB-SUBOX|Suboxone|04/23/2013| 00781724964|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781724964|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00781751587|CE:DUP-CRTROD|Duplicate Therapy|02/05/2013| 00781751687|CE:DUP-CRTROD|Duplicate Therapy|02/05/2013| 00781751787|CE:DUP-CRTROD|Duplicate Therapy|02/05/2013| 00781801701|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00781801731|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00781802801|CE:APY-FGA|Antipsychotics|04/10/2016| 00781802931|CE:MOD-ARM|Modafinil (Provigil)|02/06/2018| 00781803201|CE:APY-FGA|Antipsychotics|04/10/2016| 00781803401|CE:APY-FGA|Antipsychotics|04/10/2016| 00781803601|CE:APY-FGA|Antipsychotics|04/10/2016| 00781803731|CE:MOD-ARM|Modafinil (Provigil)|02/06/2018| 00781804531|CE:MOD-ARM|Modafinil (Provigil)|02/06/2018| 00781804601|CE:APY-FGA|Antipsychotics|04/10/2016| 00781804701|CE:APY-FGA|Antipsychotics|04/10/2016| 00781804801|CE:APY-FGA|Antipsychotics|04/10/2016| 00781804901|CE:APY-FGA|Antipsychotics|04/10/2016| 00781805331|CE:MOD-ARM|Modafinil (Provigil)|02/06/2018| 00781910572|CE:APY-SGA|Antipsychotics|04/10/2016| 00832022500|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00832022500|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00832022500|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00832022500|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00832022600|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00832022600|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00832022600|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00832022600|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00832022700|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00832022700|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00832022700|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00832022700|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00832022800|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00832022800|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00832022800|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00832022800|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00832022900|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00832022900|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00832022900|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00832022900|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00832023000|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00832023000|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00832023000|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00832023000|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00832023300|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00832023300|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00832023300|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00832023300|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00832030000|CE:APY-FGA|Antipsychotics|04/10/2016| 00832030100|CE:APY-FGA|Antipsychotics|04/10/2016| 00832030110|CE:APY-FGA|Antipsychotics|04/10/2016| 00832030200|CE:APY-FGA|Antipsychotics|04/10/2016| 00832030210|CE:APY-FGA|Antipsychotics|04/10/2016| 00832030300|CE:APY-FGA|Antipsychotics|04/10/2016| 00832030310|CE:APY-FGA|Antipsychotics|04/10/2016| 00832030400|CE:APY-FGA|Antipsychotics|04/10/2016| 00832030410|CE:APY-FGA|Antipsychotics|04/10/2016| 00832035611|CE:DRO-DOXA1|Drug Regimen Optimization|01/31/2011| 00832035711|CE:DRO-DOXA2|Drug Regimen Optimization|01/31/2011| 00832048311|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013|11/23/2020 00832048411|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013|11/30/2020 00832048511|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013|11/23/2020 00832049411|CE:APY-FGA|Antipsychotics|04/10/2016|05/31/2021 00832049511|CE:APY-FGA|Antipsychotics|04/10/2016|05/31/2021 00832049611|CE:APY-FGA|Antipsychotics|04/10/2016|05/31/2021 00832049711|CE:APY-FGA|Antipsychotics|04/10/2016|06/30/2021 00832077760|CE:ADD-KAPVAY|ADD/ADHD Agents|02/13/2014| 00832121100|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00832121101|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00832121110|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00832121200|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00832121201|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00832121210|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00832121300|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00832121301|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00832121310|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00832121400|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00832121401|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00832121410|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00832121500|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00832121501|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00832121510|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00832121600|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00832121601|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00832121610|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00832121700|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00832121701|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00832121710|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00832121800|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00832121801|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00832121850|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00832121900|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00832121901|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00832121950|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00832135811|CE:DRO-DOXA4|Drug Regimen Optimization|01/31/2011| 00832151011|CE:APY-FGA|Antipsychotics|04/10/2016| 00832152011|CE:APY-FGA|Antipsychotics|04/10/2016| 00832154011|CE:APY-FGA|Antipsychotics|04/10/2016| 00832155011|CE:APY-FGA|Antipsychotics|04/10/2016| 00832156011|CE:APY-FGA|Antipsychotics|04/10/2016| 00904001280|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00904001280|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 00904025024|CE:CCC-CCCA|Cough and Cold Agents - Clinical|12/15/2015| 00904025024|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00904025059|CE:CCC-CCCA|Cough and Cold Agents - Clinical|12/15/2015| 00904025059|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00904530624|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00904530660|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00904530680|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00904530780|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00904530909|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00904530920|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00904535196|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 00904535196|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00904535196|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 00904552261|CE:DRO-DOXA1|Drug Regimen Optimization|01/31/2011| 00904552361|CE:DRO-DOXA2|Drug Regimen Optimization|01/31/2011| 00904552461|CE:DRO-DOXA4|Drug Regimen Optimization|01/31/2011| 00904557720|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00904567661|CE:DRO-PRX10|Drug Regimen Optimization|01/31/2011| 00904567761|CE:DRO-PRX20|Drug Regimen Optimization|01/31/2011| 00904568461|CE:DRO-OMP20|Drug Regimen Optimization|01/31/2011|11/20/2020 00904572889|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013|01/31/2021 00904576444|CE:DXO-DEXBB|Dextromethorphan Overutilization|07/16/2012|12/12/2020 00904578624|CE:DXO-DEXDD|Dextromethorphan Overutilization|07/16/2012| 00904579252|CE:CCC-CCCA|Cough and Cold Agents - Clinical|12/15/2015| 00904583315|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00904583348|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00904585340|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00904585360|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00904585440|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00904585461|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00904585540|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00904585560|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00904585561|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00904586061|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00904586061|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00904586061|CE:ALP-ALP|Alprazolam|05/28/2015| 00904586061|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00904588061|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|07/31/2021 00904588061|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011|07/31/2021 00904588061|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|07/31/2021 00904588061|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|07/31/2021 00904589161|CE:DRO-PRAVA10|Drug Regimen Optimization|01/31/2011| 00904589161|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00904589261|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00904589261|CE:DRO-PRAVA20|Drug Regimen Optimization|01/31/2011| 00904589361|CE:DRO-PRAVA40|Drug Regimen Optimization|01/31/2011| 00904589361|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00904600760|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00904600760|CE:ASH-LORAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00904600760|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00904600760|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00904600761|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00904600761|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00904600761|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00904600761|CE:ASH-LORAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00904600860|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00904600860|CE:ASH-LORAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00904600860|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00904600860|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00904600861|CE:ASH-LORAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00904600861|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00904600861|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00904600861|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00904600960|CE:ASH-LORAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00904600960|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00904600960|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00904600960|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00904600961|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00904600961|CE:ASH-LORAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00904600961|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00904600961|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00904608261|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00904608461|CE:DRO-CTP10|Drug Regimen Optimization|01/31/2011| 00904608561|CE:DRO-CTP20|Drug Regimen Optimization|01/31/2011| 00904621640|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00904621740|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00904626908|CE:APY-SGA|Antipsychotics|04/10/2016| 00904627008|CE:APY-SGA|Antipsychotics|04/10/2016| 00904627108|CE:APY-SGA|Antipsychotics|04/10/2016| 00904627208|CE:APY-SGA|Antipsychotics|04/10/2016| 00904628361|CE:APY-SGA|Antipsychotics|04/10/2016| 00904628361|CE:DRO-OLANZ2.5|Drug Regimen Optimization|01/31/2011| 00904628606|CE:APY-SGA|Antipsychotics|04/10/2016| 00904628661|CE:APY-SGA|Antipsychotics|04/10/2016| 00904628706|CE:APY-SGA|Antipsychotics|04/10/2016| 00904628761|CE:APY-SGA|Antipsychotics|04/10/2016| 00904629061|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00904629061|CE:DRO-ATORV10|Drug Regimen Optimization|01/31/2011| 00904629161|CE:DRO-ATORV20|Drug Regimen Optimization|01/31/2011| 00904629161|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00904629261|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00904629261|CE:DRO-ATORV40|Drug Regimen Optimization|01/31/2011| 00904629304|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00904631256|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 00904631256|CE:CCC-CCCA|Cough and Cold Agents - Clinical|12/15/2015| 00904631256|CE:DXO-DEXI|Dextromethorphan Overutilization|07/16/2012| 00904635761|CE:DRO-RISP0.25|Drug Regimen Optimization|01/31/2011| 00904635761|CE:APY-ARI|Antipsychotics|04/10/2016| 00904635861|CE:APY-ARI|Antipsychotics|04/10/2016| 00904635861|CE:DRO-RISP0.5|Drug Regimen Optimization|01/31/2011| 00904635961|CE:APY-ARI|Antipsychotics|04/10/2016| 00904635961|CE:DRO-RISP1|Drug Regimen Optimization|01/31/2011| 00904636061|CE:APY-ARI|Antipsychotics|04/10/2016| 00904636061|CE:DRO-RISP2|Drug Regimen Optimization|01/31/2011| 00904636161|CE:APY-ARI|Antipsychotics|04/10/2016| 00904636261|CE:APY-ARI|Antipsychotics|04/10/2016| 00904636345|CE:DRO-DIVAL250|Drug Regimen Optimization|01/31/2011| 00904636361|CE:DRO-DIVAL250|Drug Regimen Optimization|01/31/2011| 00904636561|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|05/31/2021 00904636561|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|05/31/2021 00904636561|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020|05/31/2021 00904636561|CE:OPO-OOVU|Opiate Overutilization|11/05/2013|05/31/2021 00904636961|CE:DRO-AMLOD2.5|Drug Regimen Optimization|01/31/2011| 00904637061|CE:DRO-AMLOD5|Drug Regimen Optimization|01/31/2011| 00904637661|CE:APY-SGA|Antipsychotics|04/10/2016| 00904637661|CE:DRO-OLANZ10|Drug Regimen Optimization|01/31/2011| 00904637761|CE:DRO-OLANZ5|Drug Regimen Optimization|01/31/2011| 00904637761|CE:APY-SGA|Antipsychotics|04/10/2016| 00904638961|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00904639061|CE:DRO-LORSA50|Drug Regimen Optimization|01/31/2011|04/13/2021 00904639061|CE:DUP-ARB|Duplicate Therapy|02/05/2013|04/13/2021 00904639161|CE:DRO-LORSA25|Drug Regimen Optimization|01/31/2011|03/12/2021 00904639161|CE:DUP-ARB|Duplicate Therapy|02/05/2013|03/12/2021 00904642661|CE:DRO-ETP10|Drug Regimen Optimization|01/31/2011| 00904643604|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00904643604|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00904643604|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00904643604|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00904643660|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011|03/10/2021 00904643660|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|03/10/2021 00904643660|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|03/10/2021 00904643660|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|03/10/2021 00904643761|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00904643761|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00904643761|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00904643761|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00904643861|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00904643861|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00904643861|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00904643861|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00904643961|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00904643961|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00904643961|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00904643961|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00904646161|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 00904646220|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013|12/31/2020 00904646220|CE:CCC-CCCA|Cough and Cold Agents - Clinical|12/15/2015|12/31/2020 00904646320|CE:DXO-DEXN|Dextromethorphan Overutilization|07/16/2012| 00904646320|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00904646320|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 00904646320|CE:DXO-DEXQCHLD|Dextromethorphan Overutilization|07/16/2012| 00904646420|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 00904646420|CE:DXO-DEXQ|Dextromethorphan Overutilization|07/16/2012| 00904646861|CE:DRO-VENL37.5|Drug Regimen Optimization|01/31/2011| 00904646961|CE:DRO-VENL75|Drug Regimen Optimization|01/31/2011| 00904647761|CE:DRO-DONEZ5|Drug Regimen Optimization|01/31/2011| 00904650261|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 00904650261|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 00904650361|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 00904650361|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 00904650904|CE:APY-ARI|Antipsychotics|04/10/2016| 00904651006|CE:APY-ARI|Antipsychotics|04/10/2016| 00904651006|CE:DRO-ARIPI5|Drug Regimen Optimization|01/31/2011| 00904651061|CE:DRO-ARIPI5|Drug Regimen Optimization|01/31/2011| 00904651061|CE:APY-ARI|Antipsychotics|04/10/2016| 00904651106|CE:APY-ARI|Antipsychotics|04/10/2016| 00904651106|CE:DRO-ARIPI10|Drug Regimen Optimization|01/31/2011| 00904651161|CE:DRO-ARIPI10|Drug Regimen Optimization|01/31/2011| 00904651161|CE:APY-ARI|Antipsychotics|04/10/2016| 00904651204|CE:DRO-ARIPI15|Drug Regimen Optimization|01/31/2011| 00904651204|CE:APY-ARI|Antipsychotics|04/10/2016| 00904651304|CE:APY-ARI|Antipsychotics|04/10/2016| 00904651404|CE:APY-ARI|Antipsychotics|04/10/2016| 00904651661|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00904651761|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00904651961|CE:DRO-MIRTZA15|Drug Regimen Optimization|01/31/2011| 00904653061|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00904653061|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00904653061|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00904653061|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00904653061|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00904653720|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 00904653720|CE:DXO-DEXQ|Dextromethorphan Overutilization|07/16/2012| 00904655761|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00904655761|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00904655761|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00904655761|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00904655861|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00904655861|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00904655861|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00904655861|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00904655961|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00904655961|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00904655961|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00904655961|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00904656061|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00904656061|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00904656061|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 00904656061|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00904656460|CE:CCC-CCCC|Cough and Cold Agents - Clinical|12/15/2015| 00904656461|CE:CCC-CCCC|Cough and Cold Agents - Clinical|12/15/2015| 00904657004|CE:DRO-OXYBU5|Drug Regimen Optimization|01/31/2011| 00904657006|CE:DRO-OXYBU5|Drug Regimen Optimization|01/31/2011| 00904657061|CE:DRO-OXYBU5|Drug Regimen Optimization|01/31/2011| 00904658661|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011|06/30/2021 00904659204|CE:DRO-TOLTLA2|Drug Regimen Optimization|01/31/2011| 00904659961|CE:APY-FGA|Antipsychotics|04/10/2016| 00904660061|CE:APY-FGA|Antipsychotics|04/10/2016| 00904660161|CE:APY-FGA|Antipsychotics|04/10/2016| 00904661761|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00904661861|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00904663861|CE:APY-SGA|Antipsychotics|04/10/2016| 00904663961|CE:APY-SGA|Antipsychotics|04/10/2016| 00904664061|CE:APY-SGA|Antipsychotics|04/10/2016| 00904664161|CE:APY-SGA|Antipsychotics|04/10/2016| 00904664261|CE:APY-SGA|Antipsychotics|04/10/2016| 00904664361|CE:APY-SGA|Antipsychotics|04/10/2016| 00904664604|CE:LTMC-ZAF|Leukotriene Modifiers - Clinical|12/15/2015|04/23/2021 00904665640|CE:APY-ARI|Antipsychotics|04/10/2016| 00904665640|CE:DRO-ARIPI5|Drug Regimen Optimization|01/31/2011| 00904665760|CE:CCC-CCCC|Cough and Cold Agents - Clinical|12/15/2015| 00904666561|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 00904666661|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 00904666761|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 00904666825|CE:FOS-FOSRENOL|Fosrenol (Lanthanum Carbonate)|01/31/2011| 00904667104|CE:SDF-REVATIO|Sildenafil (Revatio)|01/31/2011| 00904667840|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00904667840|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00904667840|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 00904667840|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 00904671110|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00904671146|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00904671740|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00904671741|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00904671743|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00904671746|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00904671760|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00904671761|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00904671772|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00904671786|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00904671839|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 00904671839|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 00904674724|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00904674740|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00904674751|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00904674759|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00904674770|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00904674780|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00904675816|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015|04/09/2021 00904675816|CE:DXO-DEXQ|Dextromethorphan Overutilization|07/16/2012|04/09/2021 00904675859|CE:DXO-DEXQ|Dextromethorphan Overutilization|07/16/2012| 00904675859|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 00904676130|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 00904676316|CE:CCC-CCCA|Cough and Cold Agents - Clinical|12/15/2015|06/23/2021 00904676320|CE:CCC-CCCA|Cough and Cold Agents - Clinical|12/15/2015| 00904676520|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00904676720|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00904677861|CE:DRO-ROSUV5|Drug Regimen Optimization|01/31/2011| 00904677861|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00904678061|CE:DUP-STN|Duplicate Therapy|02/04/2016| 00904678061|CE:DRO-ROSUV20|Drug Regimen Optimization|01/31/2011| 00904679344|CE:DXO-DEXDD|Dextromethorphan Overutilization|07/16/2012|10/31/2020 00904680361|CE:APY-SGA|Antipsychotics|04/10/2016| 00904680561|CE:APY-SGA|Antipsychotics|04/10/2016| 00904680861|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 00904681546|CE:CCC-CCCA|Cough and Cold Agents - Clinical|12/15/2015| 00904681552|CE:CCC-CCCA|Cough and Cold Agents - Clinical|12/15/2015| 00904681646|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 00904681646|CE:DXO-DEXAA|Dextromethorphan Overutilization|07/16/2012| 00904681652|CE:DXO-DEXAA|Dextromethorphan Overutilization|07/16/2012| 00904681652|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 00904683106|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00904683106|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 00904685207|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00904685260|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00904685261|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00904685272|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00904685289|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00904690804|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 00904697940|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00904697960|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00904698516|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00904698520|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00904698640|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 00904698640|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 00904699544|CE:DXO-DEXDD|Dextromethorphan Overutilization|07/16/2012| 00904699644|CE:DXO-DEXBB|Dextromethorphan Overutilization|07/16/2012| 00904700635|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 00904701320|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 00904701320|CE:DXO-DEXQ|Dextromethorphan Overutilization|07/16/2012| 00904705040|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00904705060|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 00904791251|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00904791451|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00904791459|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 00904791480|CE:DUP-NSD|Duplicate Therapy|02/05/2013|12/31/2020 00944417910|CE:ENZ-CEP|Enzymes|11/20/2019| 00955100310|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00955100410|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00955100610|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00955100810|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00955101010|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00955101210|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00955101510|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00955101601|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 00955104090|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00955104090|CE:DRO-IRBE75|Drug Regimen Optimization|01/31/2011| 00955104190|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00955104190|CE:DRO-IRBE150|Drug Regimen Optimization|01/31/2011| 00955104290|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00955104590|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00955104590|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00955104690|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 00955104690|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 00955170210|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 00955170310|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 10147068501|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 10147068501|CE:DRO-MPHER18|Drug Regimen Optimization|01/31/2011| 10147068601|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 10147068701|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 10147068801|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 10147068801|CE:DRO-MPHER27|Drug Regimen Optimization|01/31/2011| 10147095103|CE:APY-SGA|Antipsychotics|04/10/2016| 10147095201|CE:APY-SGA|Antipsychotics|04/10/2016| 10147095203|CE:APY-SGA|Antipsychotics|04/10/2016| 10147095301|CE:APY-SGA|Antipsychotics|04/10/2016|12/31/2021 10147095303|CE:APY-SGA|Antipsychotics|04/10/2016| 10147095401|CE:APY-SGA|Antipsychotics|04/10/2016| 10147095403|CE:APY-SGA|Antipsychotics|04/10/2016| 10370010103|CE:DRO-BUPR150|Drug Regimen Optimization|01/31/2011| 10370010150|CE:DRO-BUPR150|Drug Regimen Optimization|01/31/2011| 10370011610|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 10370011710|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 10370017009|CE:DRO-DARI7.5|Drug Regimen Optimization|01/31/2011|02/28/2021 10370017011|CE:DRO-DARI7.5|Drug Regimen Optimization|01/31/2011|02/28/2021 10370022111|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 10370022111|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 10370022211|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 10370022211|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 10370022311|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 10370022311|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 10370025702|CE:ADD-KAPVAY|ADD/ADHD Agents|02/13/2014| 10370025702|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 10370051010|CE:DRO-DIVAL250|Drug Regimen Optimization|01/31/2011|08/07/2021 10370051050|CE:DRO-DIVAL250|Drug Regimen Optimization|01/31/2011|08/07/2021 10370074501|CE:DRO-GLIP5|Drug Regimen Optimization|01/31/2011| 10702000201|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 10702000301|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 10702000310|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 10702000401|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 10702000601|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702000601|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011| 10702000601|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702000610|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702000610|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011| 10702000610|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702000650|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011| 10702000650|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702000650|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702000701|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702000701|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702000701|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011| 10702000710|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011| 10702000710|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702000710|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702000750|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011| 10702000750|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702000750|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702000801|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702000801|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 10702000801|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 10702000801|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702000850|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 10702000850|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702000850|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 10702000850|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702000901|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 10702000901|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702000901|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702000901|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 10702000950|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702000950|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 10702000950|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 10702000950|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702001001|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 10702001050|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 10702001101|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 10702001110|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 10702001150|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 10702001201|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 10702001210|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 10702001250|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 10702001601|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 10702001606|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 10702001610|CE:DUP-NSD|Duplicate Therapy|02/05/2013|11/23/2020 10702001650|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 10702001801|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 10702001801|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702001801|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 10702001801|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702001850|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 10702001850|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702001850|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702001850|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 10702002301|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 10702002301|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702002301|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 10702002301|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702005501|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702005501|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702005501|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 10702005501|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 10702005503|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702005503|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 10702005503|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 10702005503|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702005601|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 10702005601|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702005601|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 10702005601|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702005650|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 10702005650|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 10702005650|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702005650|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702005701|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702005701|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702005701|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 10702005701|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 10702005750|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702005750|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 10702005750|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702005750|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 10702006501|CE:ADD-IRZen|ADD/ADHD Agents|02/13/2014| 10702006601|CE:ADD-IRZen|ADD/ADHD Agents|02/13/2014| 10702007001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702007001|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 10702007001|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 10702007001|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702007006|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 10702007006|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702007006|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702007006|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 10702007101|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 10702007101|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702007101|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 10702007101|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702007106|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 10702007106|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 10702007106|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702007106|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702007501|CE:ADD-ERMETHYL|ADD/ADHD Agents|02/13/2014| 10702007501|CE:DRO-MPHTB10|Drug Regimen Optimization|01/31/2011| 10702007601|CE:ADD-ERMETHYL|ADD/ADHD Agents|02/13/2014| 10702010001|CE:ADD-IRMETHYL|ADD/ADHD Agents|02/13/2014| 10702010101|CE:ADD-IRMETHYL|ADD/ADHD Agents|02/13/2014| 10702010201|CE:ADD-IRMETHYL|ADD/ADHD Agents|02/13/2014| 10702010601|CE:ADD-IRFOC|ADD/ADHD Agents|02/13/2014| 10702010701|CE:ADD-IRFOC|ADD/ADHD Agents|02/13/2014| 10702010801|CE:ADD-IRFOC|ADD/ADHD Agents|02/13/2014| 10702015016|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 10702015016|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702015016|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 10702015016|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702016350|CE:ADD-IRMETHYL|ADD/ADHD Agents|02/13/2014| 10702016450|CE:ADD-IRMETHYL|ADD/ADHD Agents|02/13/2014| 10702018401|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702018401|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 10702018401|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 10702018401|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702018701|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 10702018701|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 10702018701|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702018701|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702018750|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 10702018750|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702018750|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 10702018750|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702019001|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 10702019001|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702019001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702019001|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 10702019010|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702019010|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 10702019010|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702019010|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 10702019050|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 10702019050|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702019050|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702019050|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 10702019101|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702019101|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 10702019101|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702019101|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 10702019201|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 10702019201|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 10702019201|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702019201|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702019301|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 10702019301|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702019301|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 10702019301|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702019401|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 10702019401|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 10702019401|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702019401|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702034301|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702034301|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702034301|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 10702034301|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 10702034401|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702034401|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 10702034401|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 10702034401|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702034501|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702034501|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 10702034501|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 10702034501|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 11534019001|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 11534019101|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 11534019201|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 11534019301|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 11534019401|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 11534019501|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 11534019601|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 11534019701|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 11534019701|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 11534019701|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 12496009001|CE:APY-SGA|Antipsychotics|04/10/2016| 12496012001|CE:APY-SGA|Antipsychotics|04/10/2016| 12496120201|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 12496120201|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 12496120201|CE:SUB-SUBOX|Suboxone|04/23/2013| 12496120203|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 12496120203|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 12496120203|CE:SUB-SUBOX|Suboxone|04/23/2013| 12496120401|CE:SUB-SUBOX|Suboxone|04/23/2013| 12496120401|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 12496120401|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 12496120403|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 12496120403|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 12496120403|CE:SUB-SUBOX|Suboxone|04/23/2013| 12496120801|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 12496120801|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 12496120801|CE:SUB-SUBOX|Suboxone|04/23/2013| 12496120803|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 12496120803|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 12496120803|CE:SUB-SUBOX|Suboxone|04/23/2013| 12496121201|CE:SUB-SUBOX|Suboxone|04/23/2013| 12496121201|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 12496121201|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 12496121203|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 12496121203|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 12496121203|CE:SUB-SUBOX|Suboxone|04/23/2013| 12830076216|CE:CCC-CCCA|Cough and Cold Agents - Clinical|12/15/2015| 12830076216|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 12830081616|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 12830081616|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 12830081616|CE:DXO-DEXQ|Dextromethorphan Overutilization|07/16/2012| 13107000105|CE:DRO-MIRTA7.5|Drug Regimen Optimization|01/31/2011| 13107000130|CE:DRO-MIRTA7.5|Drug Regimen Optimization|01/31/2011| 13107000401|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107000401|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 13107000401|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107000401|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 13107000401|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 13107000501|CE:DRO-CTP10|Drug Regimen Optimization|01/31/2011| 13107000505|CE:DRO-CTP10|Drug Regimen Optimization|01/31/2011| 13107000601|CE:DRO-CTP20|Drug Regimen Optimization|01/31/2011| 13107000605|CE:DRO-CTP20|Drug Regimen Optimization|01/31/2011| 13107001901|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 13107001901|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 13107001901|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107001901|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107001905|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 13107001905|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107001905|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 13107001905|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107002001|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 13107002001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107002001|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 13107002001|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107002005|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107002005|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 13107002005|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 13107002005|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107002101|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107002101|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 13107002101|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 13107002101|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107002105|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107002105|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 13107002105|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107002105|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 13107002199|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107002199|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107002199|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 13107002199|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 13107003105|CE:DRO-MIRTZA15|Drug Regimen Optimization|01/31/2011| 13107003130|CE:DRO-MIRTZA15|Drug Regimen Optimization|01/31/2011| 13107003134|CE:DRO-MIRTZA15|Drug Regimen Optimization|01/31/2011| 13107003501|CE:ADD-IRZen|ADD/ADHD Agents|02/13/2014| 13107003601|CE:ADD-IRZen|ADD/ADHD Agents|02/13/2014| 13107004401|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107004401|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107004401|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 13107004401|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 13107004405|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107004405|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 13107004405|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 13107004405|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107004501|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107004501|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107004501|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 13107004501|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 13107004505|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107004505|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 13107004505|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107004505|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 13107004601|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 13107004601|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 13107004601|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107004601|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107004605|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107004605|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 13107004605|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 13107004605|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107005501|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107005501|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 13107005501|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 13107005501|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107005601|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107005601|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107005601|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 13107005601|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 13107005701|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 13107005701|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107005701|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 13107005701|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107005801|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 13107005801|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 13107005801|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107005801|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107005901|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107005901|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 13107005901|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 13107005901|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107005999|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 13107005999|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107005999|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107005999|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 13107006001|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107006001|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 13107006001|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 13107006001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107006005|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 13107006005|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 13107006005|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107006005|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107006099|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107006099|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 13107006099|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 13107006099|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107006801|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 13107007001|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 13107007201|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 13107007301|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 13107007401|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 13107008305|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107008305|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107008305|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107008305|CE:ASH-LORAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 13107008405|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107008405|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107008405|CE:ASH-LORAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 13107008405|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107008501|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107008501|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107008501|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107008501|CE:ASH-LORAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 13107008801|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107008801|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 13107008801|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 13107008801|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107008901|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107008901|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107008901|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 13107008901|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 13107008901|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 13107010301|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 13107010301|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 13107010301|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107010301|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107010401|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107010401|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107010401|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 13107010401|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 13107010701|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 13107010701|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107010701|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 13107010701|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107010801|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 13107010801|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 13107010801|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107010801|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107010901|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107010901|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 13107010901|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 13107010901|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107011905|CE:DRO-RISP0.25|Drug Regimen Optimization|01/31/2011|09/10/2021 13107011905|CE:APY-ARI|Antipsychotics|04/10/2016|09/10/2021 13107012105|CE:APY-ARI|Antipsychotics|04/10/2016|09/10/2021 13107012105|CE:DRO-RISP1|Drug Regimen Optimization|01/31/2011|09/10/2021 13107012360|CE:APY-ARI|Antipsychotics|04/10/2016|09/10/2021 13107015405|CE:DRO-PRX10|Drug Regimen Optimization|01/31/2011| 13107015430|CE:DRO-PRX10|Drug Regimen Optimization|01/31/2011| 13107015490|CE:DRO-PRX10|Drug Regimen Optimization|01/31/2011| 13107015505|CE:DRO-PRX20|Drug Regimen Optimization|01/31/2011| 13107015530|CE:DRO-PRX20|Drug Regimen Optimization|01/31/2011| 13107015590|CE:DRO-PRX20|Drug Regimen Optimization|01/31/2011| 13107015599|CE:DRO-PRX20|Drug Regimen Optimization|01/31/2011| 13107021101|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107021101|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107021101|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 13107021101|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 13107021105|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107021105|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 13107021105|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 13107021105|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107021201|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 13107021201|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107021201|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107021201|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 13107021205|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 13107021205|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 13107021205|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107021205|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107021301|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 13107021301|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107021301|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107021301|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 13107021305|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13107021305|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 13107021305|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 13107021305|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13668000701|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 13668000705|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 13668000710|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 13668000801|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 13668000805|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 13668000810|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 13668000901|CE:DRO-CTP10|Drug Regimen Optimization|01/31/2011| 13668000905|CE:DRO-CTP10|Drug Regimen Optimization|01/31/2011| 13668000909|CE:DRO-CTP10|Drug Regimen Optimization|01/31/2011| 13668001001|CE:DRO-CTP20|Drug Regimen Optimization|01/31/2011| 13668001005|CE:DRO-CTP20|Drug Regimen Optimization|01/31/2011| 13668001006|CE:DRO-CTP20|Drug Regimen Optimization|01/31/2011| 13668001830|CE:DRO-VENL37.5|Drug Regimen Optimization|01/31/2011| 13668001930|CE:DRO-VENL75|Drug Regimen Optimization|01/31/2011| 13668001990|CE:DRO-VENL75|Drug Regimen Optimization|01/31/2011| 13668003505|CE:APY-ARI|Antipsychotics|04/10/2016| 13668003505|CE:DRO-RISP0.25|Drug Regimen Optimization|01/31/2011| 13668003560|CE:DRO-RISP0.25|Drug Regimen Optimization|01/31/2011| 13668003560|CE:APY-ARI|Antipsychotics|04/10/2016| 13668003605|CE:APY-ARI|Antipsychotics|04/10/2016| 13668003605|CE:DRO-RISP0.5|Drug Regimen Optimization|01/31/2011| 13668003660|CE:APY-ARI|Antipsychotics|04/10/2016| 13668003660|CE:DRO-RISP0.5|Drug Regimen Optimization|01/31/2011| 13668003705|CE:DRO-RISP1|Drug Regimen Optimization|01/31/2011| 13668003705|CE:APY-ARI|Antipsychotics|04/10/2016| 13668003760|CE:APY-ARI|Antipsychotics|04/10/2016| 13668003760|CE:DRO-RISP1|Drug Regimen Optimization|01/31/2011| 13668003805|CE:DRO-RISP2|Drug Regimen Optimization|01/31/2011| 13668003805|CE:APY-ARI|Antipsychotics|04/10/2016| 13668003860|CE:APY-ARI|Antipsychotics|04/10/2016| 13668003860|CE:DRO-RISP2|Drug Regimen Optimization|01/31/2011| 13668003905|CE:APY-ARI|Antipsychotics|04/10/2016| 13668003960|CE:APY-ARI|Antipsychotics|04/10/2016| 13668004005|CE:APY-ARI|Antipsychotics|04/10/2016| 13668004060|CE:APY-ARI|Antipsychotics|04/10/2016| 13668006730|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668006890|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668006890|CE:DRO-VALSA80|Drug Regimen Optimization|01/31/2011| 13668006990|CE:DRO-VALSA160|Drug Regimen Optimization|01/31/2011| 13668006990|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668007090|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668007905|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 13668007930|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 13668007990|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 13668008005|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 13668008030|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 13668008090|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 13668008190|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 13668008630|CE:APY-SGA|Antipsychotics|04/10/2016| 13668008630|CE:DRO-OLAODT5|Drug Regimen Optimization|01/31/2011| 13668008830|CE:APY-SGA|Antipsychotics|04/10/2016| 13668008830|CE:DRO-OLAODT10|Drug Regimen Optimization|01/31/2011| 13668008930|CE:APY-SGA|Antipsychotics|04/10/2016| 13668009030|CE:APY-SGA|Antipsychotics|04/10/2016| 13668009605|CE:DRO-PNZ20|Drug Regimen Optimization|01/31/2011| 13668009690|CE:DRO-PNZ20|Drug Regimen Optimization|01/31/2011| 13668010210|CE:DRO-DONEZ5|Drug Regimen Optimization|01/31/2011| 13668010230|CE:DRO-DONEZ5|Drug Regimen Optimization|01/31/2011| 13668010240|CE:DRO-DONEZ5|Drug Regimen Optimization|01/31/2011| 13668010290|CE:DRO-DONEZ5|Drug Regimen Optimization|01/31/2011| 13668011310|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668011310|CE:DRO-LORSA25|Drug Regimen Optimization|01/31/2011| 13668011390|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668011390|CE:DRO-LORSA25|Drug Regimen Optimization|01/31/2011| 13668011510|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668011530|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668011590|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668011610|CE:DRO-LORS12.5|Drug Regimen Optimization|01/31/2011| 13668011610|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 13668011610|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668011630|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 13668011630|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668011630|CE:DRO-LORS12.5|Drug Regimen Optimization|01/31/2011| 13668011690|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 13668011690|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668011690|CE:DRO-LORS12.5|Drug Regimen Optimization|01/31/2011| 13668011710|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668011710|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 13668011730|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 13668011730|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668011790|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 13668011790|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668011810|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 13668011810|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668011830|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668011830|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 13668011905|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 13668011930|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 13668011990|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 13668012005|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 13668012030|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 13668012090|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 13668013201|CE:DRO-FLP2.5|Drug Regimen Optimization|01/31/2011| 13668013210|CE:DRO-FLP2.5|Drug Regimen Optimization|01/31/2011| 13668013301|CE:DRO-FLP5|Drug Regimen Optimization|01/31/2011| 13668013310|CE:DRO-FLP5|Drug Regimen Optimization|01/31/2011| 13668013501|CE:DRO-ETP5|Drug Regimen Optimization|01/31/2011| 13668013505|CE:DRO-ETP5|Drug Regimen Optimization|01/31/2011| 13668013510|CE:DRO-ETP5|Drug Regimen Optimization|01/31/2011| 13668013601|CE:DRO-ETP10|Drug Regimen Optimization|01/31/2011| 13668013605|CE:DRO-ETP10|Drug Regimen Optimization|01/31/2011| 13668013610|CE:DRO-ETP10|Drug Regimen Optimization|01/31/2011| 13668014005|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 13668014030|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 13668014090|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 13668015410|CE:DRO-EMP20|Drug Regimen Optimization|01/31/2011| 13668015430|CE:DRO-EMP20|Drug Regimen Optimization|01/31/2011| 13668015490|CE:DRO-EMP20|Drug Regimen Optimization|01/31/2011| 13668015630|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668015630|CE:DRO-TELMI20|Drug Regimen Optimization|01/31/2011| 13668015730|CE:DRO-TELMI40|Drug Regimen Optimization|01/31/2011| 13668015730|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668015830|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668015930|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668015930|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 13668016030|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 13668016030|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668016130|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668016130|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 13668016630|CE:DRO-OLANZ2.5|Drug Regimen Optimization|01/31/2011| 13668016630|CE:APY-SGA|Antipsychotics|04/10/2016| 13668016730|CE:APY-SGA|Antipsychotics|04/10/2016| 13668016730|CE:DRO-OLANZ5|Drug Regimen Optimization|01/31/2011| 13668016830|CE:APY-SGA|Antipsychotics|04/10/2016| 13668016830|CE:DRO-OLANZ7.5|Drug Regimen Optimization|01/31/2011| 13668016930|CE:DRO-OLANZ10|Drug Regimen Optimization|01/31/2011| 13668016930|CE:APY-SGA|Antipsychotics|04/10/2016| 13668017030|CE:APY-SGA|Antipsychotics|04/10/2016| 13668017130|CE:APY-SGA|Antipsychotics|04/10/2016| 13668017905|CE:DUP-STN|Duplicate Therapy|02/04/2016| 13668017905|CE:DRO-ROSUV5|Drug Regimen Optimization|01/31/2011| 13668017990|CE:DUP-STN|Duplicate Therapy|02/04/2016| 13668017990|CE:DRO-ROSUV5|Drug Regimen Optimization|01/31/2011| 13668018090|CE:DRO-ROSUV10|Drug Regimen Optimization|01/31/2011| 13668018090|CE:DUP-STN|Duplicate Therapy|02/04/2016| 13668018190|CE:DRO-ROSUV20|Drug Regimen Optimization|01/31/2011| 13668018190|CE:DUP-STN|Duplicate Therapy|02/04/2016| 13668018205|CE:DUP-STN|Duplicate Therapy|02/04/2016| 13668018230|CE:DUP-STN|Duplicate Therapy|02/04/2016| 13668018590|CE:SDF-REVATIO|Sildenafil (Revatio)|01/31/2011| 13668018905|CE:DRO-TOLTLA2|Drug Regimen Optimization|01/31/2011| 13668018930|CE:DRO-TOLTLA2|Drug Regimen Optimization|01/31/2011| 13668018990|CE:DRO-TOLTLA2|Drug Regimen Optimization|01/31/2011| 13668020230|CE:DRO-DARI7.5|Drug Regimen Optimization|01/31/2011| 13668020290|CE:DRO-DARI7.5|Drug Regimen Optimization|01/31/2011| 13668021630|CE:APY-ARI|Antipsychotics|04/10/2016| 13668021690|CE:APY-ARI|Antipsychotics|04/10/2016| 13668021730|CE:APY-ARI|Antipsychotics|04/10/2016| 13668021730|CE:DRO-ARIPI5|Drug Regimen Optimization|01/31/2011| 13668021790|CE:APY-ARI|Antipsychotics|04/10/2016| 13668021790|CE:DRO-ARIPI5|Drug Regimen Optimization|01/31/2011| 13668021830|CE:APY-ARI|Antipsychotics|04/10/2016| 13668021830|CE:DRO-ARIPI10|Drug Regimen Optimization|01/31/2011| 13668021890|CE:APY-ARI|Antipsychotics|04/10/2016| 13668021890|CE:DRO-ARIPI10|Drug Regimen Optimization|01/31/2011| 13668021930|CE:DRO-ARIPI15|Drug Regimen Optimization|01/31/2011| 13668021930|CE:APY-ARI|Antipsychotics|04/10/2016| 13668021990|CE:DRO-ARIPI15|Drug Regimen Optimization|01/31/2011| 13668021990|CE:APY-ARI|Antipsychotics|04/10/2016| 13668022030|CE:APY-ARI|Antipsychotics|04/10/2016| 13668022090|CE:APY-ARI|Antipsychotics|04/10/2016| 13668022130|CE:APY-ARI|Antipsychotics|04/10/2016| 13668022190|CE:APY-ARI|Antipsychotics|04/10/2016| 13668024830|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668024890|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668024930|CE:DRO-OLMES20|Drug Regimen Optimization|01/31/2011| 13668024930|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668024990|CE:DRO-OLMES20|Drug Regimen Optimization|01/31/2011| 13668024990|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668025030|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668025090|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668025130|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668025130|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 13668025190|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 13668025190|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668025230|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 13668025230|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668025290|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 13668025290|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668025330|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 13668025330|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668025390|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668025390|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 13668028033|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 13668028060|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 13668028133|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 13668028160|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 13668031130|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668031190|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668031230|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668031290|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668031330|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668031390|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668032430|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668032490|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668034330|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668034430|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668034530|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668034630|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668038230|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668038230|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 13668038530|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668038530|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 13668038630|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668038630|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 13668039730|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668039730|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 13668040910|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668040910|CE:DRO-LORSA50|Drug Regimen Optimization|01/31/2011| 13668040930|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668040930|CE:DRO-LORSA50|Drug Regimen Optimization|01/31/2011| 13668040990|CE:DRO-LORSA50|Drug Regimen Optimization|01/31/2011| 13668040990|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 13668044101|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 13668044101|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 13668053194|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 13668057710|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13668057710|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 13668057710|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 13668057710|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13668058130|CE:SDF-REVATIO|Sildenafil (Revatio)|01/31/2011| 13668058906|CE:APY-ARI|Antipsychotics|04/10/2016| 13668059607|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 13811068930|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 13811068930|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 13811068930|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13811068930|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13811069030|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 13811069030|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 13811069030|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13811069030|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13811069130|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 13811069130|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13811069130|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 13811069130|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13811070110|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 13811070110|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13811070110|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13811070210|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13811070210|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13811070210|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 13811070210|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 13811070310|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 13811070310|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13811070310|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13811070410|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 13811070410|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13811070410|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 13811070410|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 13811070610|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 13811070610|CE:DRO-MPHER18|Drug Regimen Optimization|01/31/2011| 13811070710|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 13811070710|CE:DRO-MPHER27|Drug Regimen Optimization|01/31/2011| 13811070810|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 13811070910|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 13913000419|CE:GAB-GRAL|Anticonvulsant Agents (Gabapentin)|02/06/2018| 13913000519|CE:GAB-GRAL|Anticonvulsant Agents (Gabapentin)|02/06/2018| 13925016604|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 13925016604|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 14539067301|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 14539067306|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 14539067401|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 14539067405|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 14539067501|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 14539067505|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 15054104005|CE:MLC-INCRELEX|Mecasemin (Increlex)|01/31/2011| 15370013010|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 15370017030|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 16571020106|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 16571020110|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 16571020111|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 16571020150|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 16571020206|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 16571020210|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 16571020211|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 16571020310|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 16571040110|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 16571040110|CE:DRO-CERTIR5|Drug Regimen Optimization|01/31/2011| 16571040210|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 16571040250|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 16714000610|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 16714001610|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 16714002610|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 16714003610|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 16714004610|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 16714005101|CE:APY-FGA|Antipsychotics|04/10/2016| 16714005610|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 16714006610|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 16714008110|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 16714008111|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 16714008210|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 16714008211|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 16714008212|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 16714008310|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 16714008311|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 16714012401|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 16714012401|CE:DRO-MPHER18|Drug Regimen Optimization|01/31/2011| 16714012501|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 16714012501|CE:DRO-MPHER27|Drug Regimen Optimization|01/31/2011| 16714012601|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 16714012701|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 16714022101|CE:AEM-ANTIEME|Antiemetics Oral|01/31/2011|12/31/2020 16714022130|CE:AEM-ANTIEME|Antiemetics Oral|01/31/2011|12/31/2020 16714022132|CE:AEM-ANTIEME|Antiemetics Oral|01/31/2011|12/31/2020 16714022401|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013|12/31/2020 16714022401|CE:DUP-ARB|Duplicate Therapy|02/05/2013|12/31/2020 16714022402|CE:DUP-ARB|Duplicate Therapy|02/05/2013|12/31/2020 16714022402|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013|12/31/2020 16714022501|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013|12/31/2020 16714022501|CE:DUP-ARB|Duplicate Therapy|02/05/2013|12/31/2020 16714022502|CE:DUP-ARB|Duplicate Therapy|02/05/2013|12/31/2020 16714022502|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013|12/31/2020 16714022504|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013|12/31/2020 16714022504|CE:DUP-ARB|Duplicate Therapy|02/05/2013|12/31/2020 16714022601|CE:DUP-ARB|Duplicate Therapy|02/05/2013|12/31/2020 16714022601|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013|12/31/2020 16714022601|CE:DRO-LORS12.5|Drug Regimen Optimization|01/31/2011|12/31/2020 16714022602|CE:DRO-LORS12.5|Drug Regimen Optimization|01/31/2011|12/31/2020 16714022602|CE:DUP-ARB|Duplicate Therapy|02/05/2013|12/31/2020 16714022602|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013|12/31/2020 16714022604|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013|12/31/2020 16714022604|CE:DUP-ARB|Duplicate Therapy|02/05/2013|12/31/2020 16714022604|CE:DRO-LORS12.5|Drug Regimen Optimization|01/31/2011|12/31/2020 16714027102|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013|12/31/2020 16714027103|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013|12/31/2020 16714033001|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 16714033002|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 16714033201|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 16714033202|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 16714045201|CE:APY-SGA|Antipsychotics|04/10/2016|12/31/2020 16714045202|CE:APY-SGA|Antipsychotics|04/10/2016|12/31/2020 16714045301|CE:APY-SGA|Antipsychotics|04/10/2016|12/31/2020 16714045302|CE:APY-SGA|Antipsychotics|04/10/2016|12/31/2020 16714045401|CE:APY-SGA|Antipsychotics|04/10/2016|12/31/2020 16714045402|CE:APY-SGA|Antipsychotics|04/10/2016|12/31/2020 16714045501|CE:APY-SGA|Antipsychotics|04/10/2016|12/31/2020 16714045601|CE:APY-SGA|Antipsychotics|04/10/2016|12/31/2020 16714045701|CE:APY-SGA|Antipsychotics|04/10/2016|12/31/2020 16714048201|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013|12/31/2020 16714048202|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013|10/31/2020 16714048203|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013|12/31/2020 16714048401|CE:DRO-DIVAL250|Drug Regimen Optimization|01/31/2011| 16714049701|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 16714049702|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 16714049801|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 16714049802|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 16714049901|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 16714049902|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 16714050301|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011|04/30/2021 16714050302|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011|05/31/2021 16714050401|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011|11/30/2020 16714050402|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011|05/31/2021 16714050501|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011|04/30/2021 16714050502|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011|04/30/2021 16714061101|CE:DRO-SRL25|Drug Regimen Optimization|01/31/2011|12/31/2020 16714061104|CE:DRO-SRL25|Drug Regimen Optimization|01/31/2011|12/31/2020 16714061105|CE:DRO-SRL25|Drug Regimen Optimization|01/31/2011|12/31/2020 16714061106|CE:DRO-SRL25|Drug Regimen Optimization|01/31/2011|12/31/2020 16714061201|CE:DRO-SRL50|Drug Regimen Optimization|01/31/2011|12/31/2020 16714061204|CE:DRO-SRL50|Drug Regimen Optimization|01/31/2011|12/31/2020 16714061205|CE:DRO-SRL50|Drug Regimen Optimization|01/31/2011|12/31/2020 16714061206|CE:DRO-SRL50|Drug Regimen Optimization|01/31/2011|12/31/2020 16714062101|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011|12/31/2020 16714062102|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011|12/31/2020 16714062201|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011|12/31/2020 16714062202|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011|12/31/2020 16714065601|CE:DRO-VENL37.5|Drug Regimen Optimization|01/31/2011| 16714066101|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 16714066102|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 16714066201|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 16714066202|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 16714066301|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011|05/31/2021 16714066302|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 16714068101|CE:DUP-STN|Duplicate Therapy|02/04/2016|12/31/2020 16714068101|CE:DRO-SIMVA5|Drug Regimen Optimization|01/31/2011|12/31/2020 16714068102|CE:DRO-SIMVA5|Drug Regimen Optimization|01/31/2011| 16714068102|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16714068201|CE:DUP-STN|Duplicate Therapy|02/04/2016|12/31/2020 16714068201|CE:DRO-SIMVA10|Drug Regimen Optimization|01/31/2011|12/31/2020 16714068202|CE:DRO-SIMVA10|Drug Regimen Optimization|01/31/2011|12/31/2020 16714068202|CE:DUP-STN|Duplicate Therapy|02/04/2016|12/31/2020 16714068203|CE:DRO-SIMVA10|Drug Regimen Optimization|01/31/2011| 16714068203|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16714068301|CE:DRO-SIMVA20|Drug Regimen Optimization|01/31/2011|12/31/2020 16714068301|CE:DUP-STN|Duplicate Therapy|02/04/2016|12/31/2020 16714068302|CE:DUP-STN|Duplicate Therapy|02/04/2016|12/31/2020 16714068302|CE:DRO-SIMVA20|Drug Regimen Optimization|01/31/2011|12/31/2020 16714068303|CE:DRO-SIMVA20|Drug Regimen Optimization|01/31/2011| 16714068303|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16714068401|CE:DRO-SIMVA40|Drug Regimen Optimization|01/31/2011|12/31/2020 16714068401|CE:DUP-STN|Duplicate Therapy|02/04/2016|12/31/2020 16714068402|CE:DUP-STN|Duplicate Therapy|02/04/2016|12/31/2020 16714068402|CE:DRO-SIMVA40|Drug Regimen Optimization|01/31/2011|12/31/2020 16714068403|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16714068403|CE:DRO-SIMVA40|Drug Regimen Optimization|01/31/2011| 16714068501|CE:DUP-STN|Duplicate Therapy|02/04/2016|12/31/2020 16714068502|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16714068503|CE:DUP-STN|Duplicate Therapy|02/04/2016|12/31/2020 16714070601|CE:DRO-MIRTA7.5|Drug Regimen Optimization|01/31/2011|02/28/2021 16714070701|CE:DRO-MIRTZA15|Drug Regimen Optimization|01/31/2011|04/30/2021 16714071401|CE:DRO-OMP10|Drug Regimen Optimization|01/31/2011| 16714071501|CE:DRO-OMP20|Drug Regimen Optimization|01/31/2011| 16714071502|CE:DRO-OMP20|Drug Regimen Optimization|01/31/2011| 16714071503|CE:DRO-OMP20|Drug Regimen Optimization|01/31/2011| 16714073101|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 16714073101|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 16714073201|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 16714073201|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 16714073202|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 16714073202|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 16714073301|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 16714073301|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 16714073302|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 16714073302|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 16714073401|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 16714073401|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 16714073501|CE:DRO-EMP20|Drug Regimen Optimization|01/31/2011|09/30/2021 16714073502|CE:DRO-EMP20|Drug Regimen Optimization|01/31/2011|11/30/2021 16714074701|CE:DRO-OMP20|Drug Regimen Optimization|01/31/2011|11/30/2021 16714074702|CE:DRO-OMP20|Drug Regimen Optimization|01/31/2011|10/31/2021 16714074703|CE:DRO-OMP20|Drug Regimen Optimization|01/31/2011|12/31/2021 16714075501|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 16714075601|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 16714075701|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 16714075801|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 16714075901|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 16714076001|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 16714077801|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 16714077802|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 16714077901|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 16714077902|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 16714078001|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 16714078002|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 16714078101|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 16714078102|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 16714078301|CE:APY-ARI|Antipsychotics|04/10/2016| 16714078401|CE:APY-ARI|Antipsychotics|04/10/2016| 16714078401|CE:DRO-ARIPI5|Drug Regimen Optimization|01/31/2011| 16714078501|CE:DRO-ARIPI10|Drug Regimen Optimization|01/31/2011| 16714078501|CE:APY-ARI|Antipsychotics|04/10/2016| 16714078601|CE:APY-ARI|Antipsychotics|04/10/2016| 16714078601|CE:DRO-ARIPI15|Drug Regimen Optimization|01/31/2011| 16714078701|CE:APY-ARI|Antipsychotics|04/10/2016| 16714078801|CE:APY-ARI|Antipsychotics|04/10/2016| 16714079901|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 16714079902|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 16714079903|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 16714079904|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 16714080201|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 16714080301|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 16714080401|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 16714080501|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 16714080601|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 16714080701|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 16714080801|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 16714082101|CE:ADD-IRMETHYL|ADD/ADHD Agents|02/13/2014| 16714082201|CE:ADD-IRMETHYL|ADD/ADHD Agents|02/13/2014| 16714082301|CE:ADD-IRMETHYL|ADD/ADHD Agents|02/13/2014| 16714082901|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 16714082901|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 16714086601|CE:APY-SGA|Antipsychotics|04/10/2016| 16714086701|CE:APY-SGA|Antipsychotics|04/10/2016| 16714086801|CE:APY-SGA|Antipsychotics|04/10/2016| 16714086901|CE:APY-SGA|Antipsychotics|04/10/2016| 16714087401|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16714087401|CE:DRO-ATORV10|Drug Regimen Optimization|01/31/2011| 16714087402|CE:DRO-ATORV10|Drug Regimen Optimization|01/31/2011| 16714087402|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16714087403|CE:DRO-ATORV10|Drug Regimen Optimization|01/31/2011| 16714087403|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16714087501|CE:DRO-ATORV20|Drug Regimen Optimization|01/31/2011| 16714087501|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16714087502|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16714087502|CE:DRO-ATORV20|Drug Regimen Optimization|01/31/2011| 16714087503|CE:DRO-ATORV20|Drug Regimen Optimization|01/31/2011| 16714087503|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16714087601|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16714087601|CE:DRO-ATORV40|Drug Regimen Optimization|01/31/2011| 16714087602|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16714087602|CE:DRO-ATORV40|Drug Regimen Optimization|01/31/2011| 16714087603|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16714087603|CE:DRO-ATORV40|Drug Regimen Optimization|01/31/2011| 16714087701|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16714087702|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16714087703|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16714088301|CE:DES-DESMO|Desmopressin|05/25/2012| 16714088401|CE:DES-DESMO|Desmopressin|05/25/2012| 16714089101|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 16714089801|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 16714089802|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 16714089803|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 16714089901|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 16714089902|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 16714090301|CE:DRO-VENL37.5|Drug Regimen Optimization|01/31/2011| 16714090302|CE:DRO-VENL37.5|Drug Regimen Optimization|01/31/2011| 16714090401|CE:DRO-VENL75|Drug Regimen Optimization|01/31/2011| 16714090402|CE:DRO-VENL75|Drug Regimen Optimization|01/31/2011| 16714093601|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 16714093701|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 16714094801|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 16714094901|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 16714095001|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 16714095201|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 16714095301|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 16714095401|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 16714097601|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 16714097901|CE:DRO-EMP20|Drug Regimen Optimization|01/31/2011| 16714097902|CE:DRO-EMP20|Drug Regimen Optimization|01/31/2011| 16714098801|CE:DRO-ROSUV5|Drug Regimen Optimization|01/31/2011| 16714098801|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16714098901|CE:DRO-ROSUV10|Drug Regimen Optimization|01/31/2011| 16714098901|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16714099001|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16714099001|CE:DRO-ROSUV20|Drug Regimen Optimization|01/31/2011| 16714099101|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16729000415|CE:DRO-SIMVA10|Drug Regimen Optimization|01/31/2011| 16729000415|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16729000417|CE:DRO-SIMVA10|Drug Regimen Optimization|01/31/2011| 16729000417|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16729000515|CE:DRO-SIMVA20|Drug Regimen Optimization|01/31/2011| 16729000515|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16729000517|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16729000517|CE:DRO-SIMVA20|Drug Regimen Optimization|01/31/2011| 16729000615|CE:DRO-SIMVA40|Drug Regimen Optimization|01/31/2011| 16729000615|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16729000617|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16729000617|CE:DRO-SIMVA40|Drug Regimen Optimization|01/31/2011| 16729000715|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16729000717|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16729000815|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16729000815|CE:DRO-PRAVA10|Drug Regimen Optimization|01/31/2011| 16729000816|CE:DRO-PRAVA10|Drug Regimen Optimization|01/31/2011| 16729000816|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16729000915|CE:DRO-PRAVA20|Drug Regimen Optimization|01/31/2011| 16729000915|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16729000916|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16729000916|CE:DRO-PRAVA20|Drug Regimen Optimization|01/31/2011| 16729000917|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16729000917|CE:DRO-PRAVA20|Drug Regimen Optimization|01/31/2011| 16729001015|CE:DRO-PRAVA40|Drug Regimen Optimization|01/31/2011| 16729001015|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16729001016|CE:DRO-PRAVA40|Drug Regimen Optimization|01/31/2011| 16729001016|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16729001017|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16729001017|CE:DRO-PRAVA40|Drug Regimen Optimization|01/31/2011| 16729001115|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16729001116|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16729002010|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 16729002015|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 16729002016|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 16729002110|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 16729002115|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 16729002116|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 16729002210|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 16729002215|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 16729002216|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 16729004417|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16729004417|CE:DRO-ATORV10|Drug Regimen Optimization|01/31/2011| 16729004517|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16729004517|CE:DRO-ATORV20|Drug Regimen Optimization|01/31/2011| 16729004617|CE:DRO-ATORV40|Drug Regimen Optimization|01/31/2011| 16729004617|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16729004716|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16729009512|CE:APY-SGA|Antipsychotics|04/10/2016| 16729009612|CE:APY-SGA|Antipsychotics|04/10/2016| 16729009712|CE:APY-SGA|Antipsychotics|04/10/2016| 16729010912|CE:APY-SGA|Antipsychotics|04/10/2016| 16729011910|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 16729011915|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 16729013212|CE:APY-SGA|Antipsychotics|04/10/2016| 16729013600|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 16729013600|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 16729013600|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 16729013600|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 16729013616|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 16729013616|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 16729013616|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 16729013616|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 16729013700|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 16729013700|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 16729013700|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 16729013700|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 16729013716|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 16729013716|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 16729013716|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 16729013716|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 16729013800|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 16729013800|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 16729013800|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 16729013800|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 16729013816|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 16729013816|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 16729013816|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 16729013816|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 16729014101|CE:APY-SGA|Antipsychotics|04/10/2016| 16729014116|CE:APY-SGA|Antipsychotics|04/10/2016| 16729014201|CE:APY-SGA|Antipsychotics|04/10/2016| 16729014216|CE:APY-SGA|Antipsychotics|04/10/2016| 16729014501|CE:APY-SGA|Antipsychotics|04/10/2016| 16729014517|CE:APY-SGA|Antipsychotics|04/10/2016| 16729014601|CE:APY-SGA|Antipsychotics|04/10/2016| 16729014617|CE:APY-SGA|Antipsychotics|04/10/2016| 16729014701|CE:APY-SGA|Antipsychotics|04/10/2016| 16729014717|CE:APY-SGA|Antipsychotics|04/10/2016| 16729014801|CE:APY-SGA|Antipsychotics|04/10/2016| 16729014817|CE:APY-SGA|Antipsychotics|04/10/2016| 16729014912|CE:APY-SGA|Antipsychotics|04/10/2016| 16729014917|CE:APY-SGA|Antipsychotics|04/10/2016| 16729015001|CE:APY-SGA|Antipsychotics|04/10/2016| 16729015016|CE:APY-SGA|Antipsychotics|04/10/2016| 16729015615|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16729015615|CE:DRO-SIMVA5|Drug Regimen Optimization|01/31/2011| 16729016801|CE:DRO-ETP5|Drug Regimen Optimization|01/31/2011| 16729016901|CE:DRO-ETP10|Drug Regimen Optimization|01/31/2011| 16729018201|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 16729018217|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 16729018301|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 16729018317|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 16729018401|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 16729018417|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 16729021101|CE:DRO-DOXA1|Drug Regimen Optimization|01/31/2011| 16729021301|CE:DRO-DOXA4|Drug Regimen Optimization|01/31/2011| 16729021510|CE:DRO-SRL25|Drug Regimen Optimization|01/31/2011| 16729021615|CE:DRO-SRL50|Drug Regimen Optimization|01/31/2011| 16729021616|CE:DRO-SRL50|Drug Regimen Optimization|01/31/2011| 16729027801|CE:APY-ARI|Antipsychotics|04/10/2016| 16729027810|CE:APY-ARI|Antipsychotics|04/10/2016| 16729027901|CE:DRO-ARIPI5|Drug Regimen Optimization|01/31/2011| 16729027901|CE:APY-ARI|Antipsychotics|04/10/2016| 16729027910|CE:APY-ARI|Antipsychotics|04/10/2016| 16729027910|CE:DRO-ARIPI5|Drug Regimen Optimization|01/31/2011| 16729028001|CE:DRO-ARIPI10|Drug Regimen Optimization|01/31/2011| 16729028001|CE:APY-ARI|Antipsychotics|04/10/2016| 16729028010|CE:APY-ARI|Antipsychotics|04/10/2016| 16729028010|CE:DRO-ARIPI10|Drug Regimen Optimization|01/31/2011| 16729028101|CE:APY-ARI|Antipsychotics|04/10/2016| 16729028101|CE:DRO-ARIPI15|Drug Regimen Optimization|01/31/2011| 16729028110|CE:DRO-ARIPI15|Drug Regimen Optimization|01/31/2011| 16729028110|CE:APY-ARI|Antipsychotics|04/10/2016| 16729028201|CE:APY-ARI|Antipsychotics|04/10/2016| 16729028210|CE:APY-ARI|Antipsychotics|04/10/2016| 16729028301|CE:APY-ARI|Antipsychotics|04/10/2016| 16729028310|CE:APY-ARI|Antipsychotics|04/10/2016| 16729028415|CE:DRO-ROSUV5|Drug Regimen Optimization|01/31/2011| 16729028415|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16729028417|CE:DRO-ROSUV5|Drug Regimen Optimization|01/31/2011| 16729028417|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16729028515|CE:DRO-ROSUV10|Drug Regimen Optimization|01/31/2011| 16729028515|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16729028517|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16729028517|CE:DRO-ROSUV10|Drug Regimen Optimization|01/31/2011| 16729028615|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16729028615|CE:DRO-ROSUV20|Drug Regimen Optimization|01/31/2011| 16729028617|CE:DRO-ROSUV20|Drug Regimen Optimization|01/31/2011| 16729028617|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16729028710|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16729028715|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16729028717|CE:DUP-STN|Duplicate Therapy|02/04/2016| 16729031701|CE:DRO-OXYBU5|Drug Regimen Optimization|01/31/2011| 16729032110|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 16729032110|CE:DRO-OLMES20|Drug Regimen Optimization|01/31/2011| 16729032115|CE:DRO-OLMES20|Drug Regimen Optimization|01/31/2011| 16729032115|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 16729032117|CE:DRO-OLMES20|Drug Regimen Optimization|01/31/2011| 16729032117|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 16729032210|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 16729032215|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 16729032217|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 16729036615|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 16729036615|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 16729036715|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 16729036715|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 16729036815|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 16729036815|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 16729041401|CE:DRO-DOXA2|Drug Regimen Optimization|01/31/2011| 16729041417|CE:DRO-DOXA2|Drug Regimen Optimization|01/31/2011| 16729042101|CE:TIM-TIM|Topical Immunomodulators ( Elidel & Protopic)|01/31/2011| 16729042110|CE:TIM-TIM|Topical Immunomodulators ( Elidel & Protopic)|01/31/2011| 16729042112|CE:TIM-TIM|Topical Immunomodulators ( Elidel & Protopic)|01/31/2011| 16729042201|CE:TIM-PRO|Topical Immunomodulators ( Elidel & Protopic)|01/31/2011| 16729042210|CE:TIM-PRO|Topical Immunomodulators ( Elidel & Protopic)|01/31/2011| 16729042212|CE:TIM-PRO|Topical Immunomodulators ( Elidel & Protopic)|01/31/2011| 16729044310|CE:DRO-BUPR150|Drug Regimen Optimization|01/31/2011| 16729044315|CE:DRO-BUPR150|Drug Regimen Optimization|01/31/2011| 16729044316|CE:DRO-BUPR150|Drug Regimen Optimization|01/31/2011| 17478017224|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 17478017324|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 17478017424|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 18860010110|CE:APY-SGA|Antipsychotics|04/10/2016|11/30/2020 18860010410|CE:APY-SGA|Antipsychotics|04/10/2016|11/30/2020 21724070105|CE:ADD-IRPROC|ADD/ADHD Agents|02/13/2014| 21922000909|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 23155000810|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 23155000910|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 23155002101|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 23155002201|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 23155029251|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 23155031751|CE:APY-ARI|Antipsychotics|04/10/2016| 23155048901|CE:DES-DESMO|Desmopressin|05/25/2012| 23155049001|CE:DES-DESMO|Desmopressin|05/25/2012| 23155050001|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 23155050005|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 23155050010|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 23155050101|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 23155050105|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 23155050110|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 23155050201|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 23155050205|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 23155053102|CE:FOS-FOSRENOL|Fosrenol (Lanthanum Carbonate)|01/31/2011| 23155060403|CE:MOD-MOD|Modafinil (Provigil)|11/06/2012| 23155060403|CE:MOD-MOD|Modafinil (Provigil)|11/08/2012| 23155060409|CE:MOD-MOD|Modafinil (Provigil)|11/06/2012| 23155060409|CE:MOD-MOD|Modafinil (Provigil)|11/08/2012| 23155060503|CE:MOD-MOD|Modafinil (Provigil)|11/06/2012| 23155060503|CE:MOD-MOD|Modafinil (Provigil)|11/08/2012| 23155060509|CE:MOD-MOD|Modafinil (Provigil)|11/06/2012| 23155060509|CE:MOD-MOD|Modafinil (Provigil)|11/08/2012| 23155062102|CE:FOS-FOSRENOL|Fosrenol (Lanthanum Carbonate)|01/31/2011| 23155064409|CE:DRO-LORSA25|Drug Regimen Optimization|01/31/2011| 23155064409|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 23155064410|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 23155064410|CE:DRO-LORSA25|Drug Regimen Optimization|01/31/2011| 23155064503|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 23155064503|CE:DRO-LORSA50|Drug Regimen Optimization|01/31/2011| 23155064509|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 23155064509|CE:DRO-LORSA50|Drug Regimen Optimization|01/31/2011| 23155064510|CE:DRO-LORSA50|Drug Regimen Optimization|01/31/2011| 23155064510|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 23155064603|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 23155064609|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 23155064610|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 23359003216|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 23359003216|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 23359004016|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 23359004016|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 23359004016|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 23359004016|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 23594010105|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 23594050501|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 23594050501|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 23594050521|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 23594050521|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 23594050548|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 23594050548|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 23594050550|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 23594050550|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 23635058110|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 23635058110|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 23635058110|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 23635058110|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 23635058210|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 23635058210|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 23635058210|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 23635058210|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 24338002210|CE:ADD-IREVT|ADD/ADHD Agents|12/18/2019| 24338002210|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 24338002610|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 24338002610|CE:ADD-IREVT|ADD/ADHD Agents|12/18/2019| 24338085010|CE:ADD-IRZen|ADD/ADHD Agents|02/13/2014| 24338085110|CE:ADD-IRZen|ADD/ADHD Agents|02/13/2014| 24338085210|CE:ADD-IRZen|ADD/ADHD Agents|02/13/2014| 24338085310|CE:ADD-IRZen|ADD/ADHD Agents|02/13/2014| 24338085410|CE:ADD-IRZen|ADD/ADHD Agents|02/13/2014| 24338085510|CE:ADD-IRZen|ADD/ADHD Agents|02/13/2014| 24338085610|CE:ADD-IRZen|ADD/ADHD Agents|02/13/2014| 24385035926|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 24385035926|CE:DXO-DEXQ|Dextromethorphan Overutilization|07/16/2012| 24385035934|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 24385035934|CE:DXO-DEXQ|Dextromethorphan Overutilization|07/16/2012| 24385046378|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015|10/31/2020 24385046378|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013|10/31/2020 24385047199|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 24385053126|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 24385054662|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 24385060471|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 24385060478|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 24385064771|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 24385064778|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 24385099865|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 24385099875|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 24478007401|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 24478007501|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 24478007601|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 24478032102|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 24478032204|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 24478032305|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 24478032406|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 24510005010|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 24510005010|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 24510005010|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 24510005010|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 24510005860|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 24510005860|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 24510005860|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 24510005860|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 24510007510|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 24510007510|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 24510007510|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 24510007510|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 24510010010|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 24510010010|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 24510010010|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 24510010010|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 24510011010|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 24510011010|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 24510011010|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 24510011010|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 24510011010|CE:OXC-LD OXY|Oxycontin (Narcotic Analgesic)|01/31/2011| 24510011510|CE:OXC-LD OXY|Oxycontin (Narcotic Analgesic)|01/31/2011| 24510011510|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 24510011510|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 24510011510|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 24510011510|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 24510011660|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 24510011660|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 24510011660|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 24510011660|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 24510012010|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 24510012010|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 24510012010|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 24510012010|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 24510012010|CE:OXC-LD OXY|Oxycontin (Narcotic Analgesic)|01/31/2011| 24510013010|CE:OXC-LD OXY|Oxycontin (Narcotic Analgesic)|01/31/2011| 24510013010|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 24510013010|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 24510013010|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 24510013010|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 24510014010|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 24510014010|CE:OXC-LD OXY|Oxycontin (Narcotic Analgesic)|01/31/2011| 24510014010|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 24510014010|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 24510014010|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 24510017460|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 24510017460|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 24510017460|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 24510017460|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 24510023260|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 24510023260|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 24510023260|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 24510023260|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 24510029160|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 24510029160|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 24510029160|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 24510029160|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 24979001101|CE:DRO-NFP30|Drug Regimen Optimization|01/31/2011| 24979001112|CE:DRO-NFP30|Drug Regimen Optimization|01/31/2011| 24979003504|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011| 24979003504|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 24979003504|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 24979003604|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 24979003604|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011| 24979003604|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 24979010102|CE:DRO-BUPR150|Drug Regimen Optimization|01/31/2011| 24979010106|CE:DRO-BUPR150|Drug Regimen Optimization|01/31/2011| 24979010107|CE:DRO-BUPR150|Drug Regimen Optimization|01/31/2011| 24979053301|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 24979053401|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 24979053601|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 24979053801|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 25208020109|CE:DUP-STN|Duplicate Therapy|02/04/2016| 25208020209|CE:DUP-STN|Duplicate Therapy|02/04/2016| 27241000106|CE:DRO-RISP1|Drug Regimen Optimization|01/31/2011| 27241000106|CE:APY-ARI|Antipsychotics|04/10/2016| 27241000150|CE:DRO-RISP1|Drug Regimen Optimization|01/31/2011| 27241000150|CE:APY-ARI|Antipsychotics|04/10/2016| 27241000206|CE:DRO-RISP0.25|Drug Regimen Optimization|01/31/2011| 27241000206|CE:APY-ARI|Antipsychotics|04/10/2016| 27241000250|CE:APY-ARI|Antipsychotics|04/10/2016| 27241000250|CE:DRO-RISP0.25|Drug Regimen Optimization|01/31/2011| 27241000306|CE:APY-ARI|Antipsychotics|04/10/2016| 27241000306|CE:DRO-RISP0.5|Drug Regimen Optimization|01/31/2011| 27241000350|CE:APY-ARI|Antipsychotics|04/10/2016| 27241000350|CE:DRO-RISP0.5|Drug Regimen Optimization|01/31/2011| 27241000406|CE:DRO-RISP2|Drug Regimen Optimization|01/31/2011| 27241000406|CE:APY-ARI|Antipsychotics|04/10/2016| 27241000450|CE:APY-ARI|Antipsychotics|04/10/2016| 27241000450|CE:DRO-RISP2|Drug Regimen Optimization|01/31/2011| 27241000506|CE:APY-ARI|Antipsychotics|04/10/2016| 27241000550|CE:APY-ARI|Antipsychotics|04/10/2016| 27241000606|CE:APY-ARI|Antipsychotics|04/10/2016| 27241000650|CE:APY-ARI|Antipsychotics|04/10/2016| 27241001531|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 27241001603|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 27241001609|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 27241001703|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 27241001709|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 27241001803|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 27241001809|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 27241001890|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 27241005103|CE:APY-ARI|Antipsychotics|04/10/2016| 27241005108|CE:APY-ARI|Antipsychotics|04/10/2016| 27241005203|CE:APY-ARI|Antipsychotics|04/10/2016| 27241005203|CE:DRO-ARIPI5|Drug Regimen Optimization|01/31/2011| 27241005208|CE:APY-ARI|Antipsychotics|04/10/2016| 27241005208|CE:DRO-ARIPI5|Drug Regimen Optimization|01/31/2011| 27241005303|CE:APY-ARI|Antipsychotics|04/10/2016| 27241005303|CE:DRO-ARIPI10|Drug Regimen Optimization|01/31/2011| 27241005308|CE:DRO-ARIPI10|Drug Regimen Optimization|01/31/2011| 27241005308|CE:APY-ARI|Antipsychotics|04/10/2016| 27241005403|CE:DRO-ARIPI15|Drug Regimen Optimization|01/31/2011| 27241005403|CE:APY-ARI|Antipsychotics|04/10/2016| 27241005408|CE:APY-ARI|Antipsychotics|04/10/2016| 27241005408|CE:DRO-ARIPI15|Drug Regimen Optimization|01/31/2011| 27241005503|CE:APY-ARI|Antipsychotics|04/10/2016| 27241005508|CE:APY-ARI|Antipsychotics|04/10/2016| 27241005603|CE:APY-ARI|Antipsychotics|04/10/2016| 27241005608|CE:APY-ARI|Antipsychotics|04/10/2016| 27241008303|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 27241008309|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 27241008403|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 27241008409|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 27241008503|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 27241008509|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 27241008603|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 27241008609|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 27241010806|CE:ADD-KAPVAY|ADD/ADHD Agents|02/13/2014| 27241012302|CE:SDF-REVATIO|Sildenafil (Revatio)|01/31/2011| 27241012403|CE:SDF-REVATIO|Sildenafil (Revatio)|01/31/2011| 27241012502|CE:RAN-RAN|Ranolazine|05/25/2012| 27241012602|CE:RAN-RAN|Ranolazine|05/25/2012| 27241015504|CE:DRO-OXYBU5|Drug Regimen Optimization|01/31/2011| 27241015508|CE:DRO-OXYBU5|Drug Regimen Optimization|01/31/2011| 27241017529|CE:SDF-REVSUSP|Sildenafil (Revatio)|09/01/2015| 27808003301|CE:DUP-MLX|Duplicate Therapy|02/05/2013| 27808003501|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 27808003501|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 27808003501|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 27808003501|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 27808003502|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 27808003502|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 27808003502|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 27808003502|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 27808003503|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 27808003503|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 27808003503|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 27808003503|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 27808003601|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 27808003601|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 27808003601|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 27808003601|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 27808003602|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 27808003602|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 27808003602|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 27808003602|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 27808003603|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 27808003603|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 27808003603|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 27808003603|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 27808003701|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 27808003701|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 27808003701|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 27808003701|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 27808003702|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 27808003702|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 27808003702|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 27808003702|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 27808003703|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 27808003703|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 27808003703|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 27808003703|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 27808005801|CE:ADD-IRMETHYL|ADD/ADHD Agents|02/13/2014| 27808005901|CE:ADD-IRMETHYL|ADD/ADHD Agents|02/13/2014| 27808006502|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 27808006502|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 27808006502|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 27808006502|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 27808006502|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 27808006502|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 27808008201|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 27808008201|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 27808008201|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 27808008201|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 27808008202|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 27808008202|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 27808008202|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 27808008202|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 27808008501|CE:ADD-IRPROC|ADD/ADHD Agents|02/13/2014| 27808008601|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 27808008601|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 27808008601|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 27808008601|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 27808008601|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 27808008602|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 27808008602|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 27808008602|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 27808008602|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 27808008602|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 27808009101|CE:ADD-IRFOC|ADD/ADHD Agents|02/13/2014| 27808009201|CE:ADD-IRFOC|ADD/ADHD Agents|02/13/2014| 27808009301|CE:ADD-IRFOC|ADD/ADHD Agents|02/13/2014| 27808010201|CE:ADD-ERDYA|ADD/ADHD Agents|01/26/2017| 27808011401|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 27808011401|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 27808011401|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 27808011401|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 27808011402|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 27808011402|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 27808011402|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 27808011402|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 27808011501|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 27808011501|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 27808011501|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 27808011501|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 27808011502|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 27808011502|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 27808011502|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 27808011502|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 27808011601|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 27808011601|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 27808011601|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 27808011601|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 27808011602|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 27808011602|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 27808011602|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 27808011602|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 27808015501|CE:DUP-STN|Duplicate Therapy|02/04/2016| 27808015501|CE:DRO-ROSUV5|Drug Regimen Optimization|01/31/2011| 27808015503|CE:DUP-STN|Duplicate Therapy|02/04/2016| 27808015503|CE:DRO-ROSUV5|Drug Regimen Optimization|01/31/2011| 27808015601|CE:DRO-ROSUV10|Drug Regimen Optimization|01/31/2011| 27808015601|CE:DUP-STN|Duplicate Therapy|02/04/2016| 27808015603|CE:DUP-STN|Duplicate Therapy|02/04/2016| 27808015603|CE:DRO-ROSUV10|Drug Regimen Optimization|01/31/2011| 27808015701|CE:DRO-ROSUV20|Drug Regimen Optimization|01/31/2011| 27808015701|CE:DUP-STN|Duplicate Therapy|02/04/2016| 27808015703|CE:DUP-STN|Duplicate Therapy|02/04/2016| 27808015703|CE:DRO-ROSUV20|Drug Regimen Optimization|01/31/2011| 27808015801|CE:DUP-STN|Duplicate Therapy|02/04/2016| 27808015803|CE:DUP-STN|Duplicate Therapy|02/04/2016| 28595080130|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 28595080208|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 28595080316|CE:CCC-CCCA|Cough and Cold Agents - Clinical|12/15/2015| 28595080316|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 28595080416|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 28595080416|CE:DXO-DEXK|Dextromethorphan Overutilization|07/16/2012| 28595080416|CE:DXO-DEXI|Dextromethorphan Overutilization|07/16/2012| 28595080416|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 28595090060|CE:CCC-CCCA|Cough and Cold Agents - Clinical|12/15/2015| 28595090060|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 29033000101|CE:DUP-MLX|Duplicate Therapy|02/05/2013| 29033000201|CE:DUP-MLX|Duplicate Therapy|02/05/2013| 29033001201|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 29033001301|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 29033002602|CE:FOS-FOSRENOL|Fosrenol (Lanthanum Carbonate)|01/31/2011| 29033020701|CE:CCA-LDCARIS|Carisoprodol Containing Agents|01/31/2011| 29033020701|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 29033020701|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 29300012401|CE:DRO-MELOX7.5|Drug Regimen Optimization|01/31/2011| 29300012401|CE:COX-MOBIC|COX-2 Inhibitors|01/31/2011| 29300012401|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 29300012410|CE:COX-MOBIC|COX-2 Inhibitors|01/31/2011| 29300012410|CE:DRO-MELOX7.5|Drug Regimen Optimization|01/31/2011| 29300012410|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 29300012501|CE:COX-MOBIC|COX-2 Inhibitors|01/31/2011| 29300012501|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 29300012510|CE:COX-MOBIC|COX-2 Inhibitors|01/31/2011| 29300012510|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 29300012801|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 29300012810|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 29300012901|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 29300012910|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 29300013001|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 29300013005|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 29300013010|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 29300013101|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 29300013201|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 29300014701|CE:APY-SGA|Antipsychotics|04/10/2016| 29300014710|CE:APY-SGA|Antipsychotics|04/10/2016| 29300014801|CE:APY-SGA|Antipsychotics|04/10/2016| 29300014810|CE:APY-SGA|Antipsychotics|04/10/2016| 29300014901|CE:APY-SGA|Antipsychotics|04/10/2016| 29300015001|CE:APY-SGA|Antipsychotics|04/10/2016| 29300015101|CE:APY-SGA|Antipsychotics|04/10/2016| 29300015116|CE:APY-SGA|Antipsychotics|04/10/2016| 29300015201|CE:APY-SGA|Antipsychotics|04/10/2016| 29300018701|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 29300018705|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 29300018713|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 29300018801|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 29300018805|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 29300018813|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 29300018901|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 29300018905|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 29300018913|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 29300022010|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 29300022013|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 29300022019|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 29300022110|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 29300022113|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 29300022119|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 29300022210|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 29300022213|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 29300022219|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 29300024105|CE:DRO-AMLOD2.5|Drug Regimen Optimization|01/31/2011| 29300024110|CE:DRO-AMLOD2.5|Drug Regimen Optimization|01/31/2011| 29300024119|CE:DRO-AMLOD2.5|Drug Regimen Optimization|01/31/2011| 29300024205|CE:DRO-AMLOD5|Drug Regimen Optimization|01/31/2011| 29300024210|CE:DRO-AMLOD5|Drug Regimen Optimization|01/31/2011| 29300024219|CE:DRO-AMLOD5|Drug Regimen Optimization|01/31/2011| 29300025087|CE:DRO-DONEODT5|Drug Regimen Optimization|01/31/2011| 29300025501|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 29300025601|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 29300025605|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 29300032813|CE:DRO-SOLAF5|Drug Regimen Optimization|01/31/2011| 29300032819|CE:DRO-SOLAF5|Drug Regimen Optimization|01/31/2011| 29300035501|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 29300035501|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 29300035501|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 29300035501|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 29300035505|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 29300035505|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 29300035505|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 29300035505|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 29300035510|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 29300035510|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 29300035510|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 29300035510|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722000230|CE:DRO-VENL37.5|Drug Regimen Optimization|01/31/2011| 31722000290|CE:DRO-VENL37.5|Drug Regimen Optimization|01/31/2011| 31722000330|CE:DRO-VENL75|Drug Regimen Optimization|01/31/2011| 31722000390|CE:DRO-VENL75|Drug Regimen Optimization|01/31/2011| 31722017301|CE:ADD-IRMETHYL|ADD/ADHD Agents|02/13/2014| 31722017401|CE:ADD-IRMETHYL|ADD/ADHD Agents|02/13/2014| 31722017501|CE:ADD-IRMETHYL|ADD/ADHD Agents|02/13/2014| 31722019101|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722019101|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722019101|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 31722019101|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 31722019205|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 31722019205|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722019205|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722019205|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 31722019301|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 31722019301|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 31722019301|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722019301|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722019305|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722019305|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722019305|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 31722019305|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 31722019401|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722019401|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 31722019401|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722019401|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 31722051010|CE:DRO-SIMVA5|Drug Regimen Optimization|01/31/2011|12/31/2020 31722051010|CE:DUP-STN|Duplicate Therapy|02/04/2016|12/31/2020 31722051090|CE:DRO-SIMVA5|Drug Regimen Optimization|01/31/2011|12/31/2020 31722051090|CE:DUP-STN|Duplicate Therapy|02/04/2016|12/31/2020 31722051110|CE:DRO-SIMVA10|Drug Regimen Optimization|01/31/2011|12/31/2020 31722051110|CE:DUP-STN|Duplicate Therapy|02/04/2016|12/31/2020 31722051190|CE:DUP-STN|Duplicate Therapy|02/04/2016|12/31/2020 31722051190|CE:DRO-SIMVA10|Drug Regimen Optimization|01/31/2011|12/31/2020 31722051210|CE:DRO-SIMVA20|Drug Regimen Optimization|01/31/2011|12/31/2020 31722051210|CE:DUP-STN|Duplicate Therapy|02/04/2016|12/31/2020 31722051290|CE:DRO-SIMVA20|Drug Regimen Optimization|01/31/2011|12/31/2020 31722051290|CE:DUP-STN|Duplicate Therapy|02/04/2016|12/31/2020 31722051310|CE:DUP-STN|Duplicate Therapy|02/04/2016|12/31/2020 31722051310|CE:DRO-SIMVA40|Drug Regimen Optimization|01/31/2011|12/31/2020 31722051390|CE:DUP-STN|Duplicate Therapy|02/04/2016|12/31/2020 31722051390|CE:DRO-SIMVA40|Drug Regimen Optimization|01/31/2011|12/31/2020 31722051490|CE:DUP-STN|Duplicate Therapy|02/04/2016|12/31/2020 31722053301|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722053301|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722053305|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722053305|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722053401|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722053401|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722053405|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722053405|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722054201|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 31722054301|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 31722055190|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 31722056501|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 31722056560|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 31722057210|CE:DRO-EMP20|Drug Regimen Optimization|01/31/2011| 31722057230|CE:DRO-EMP20|Drug Regimen Optimization|01/31/2011| 31722057290|CE:DRO-EMP20|Drug Regimen Optimization|01/31/2011| 31722060730|CE:DRO-TOLTLA2|Drug Regimen Optimization|01/31/2011| 31722064730|CE:SDF-REVATIO|Sildenafil (Revatio)|01/31/2011| 31722065931|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 31722070005|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 31722070005|CE:DRO-LORSA25|Drug Regimen Optimization|01/31/2011| 31722070010|CE:DRO-LORSA25|Drug Regimen Optimization|01/31/2011| 31722070010|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 31722070090|CE:DRO-LORSA25|Drug Regimen Optimization|01/31/2011| 31722070090|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 31722070110|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 31722070110|CE:DRO-LORSA50|Drug Regimen Optimization|01/31/2011| 31722070130|CE:DRO-LORSA50|Drug Regimen Optimization|01/31/2011| 31722070130|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 31722070190|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 31722070190|CE:DRO-LORSA50|Drug Regimen Optimization|01/31/2011| 31722070210|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 31722070230|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 31722070290|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 31722071290|CE:DRO-PNZ20|Drug Regimen Optimization|01/31/2011| 31722072610|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 31722072630|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 31722072690|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 31722072730|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 31722072790|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 31722072830|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 31722072890|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 31722072930|CE:DRO-IRBE75|Drug Regimen Optimization|01/31/2011| 31722072930|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 31722072990|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 31722072990|CE:DRO-IRBE75|Drug Regimen Optimization|01/31/2011| 31722073030|CE:DRO-IRBE150|Drug Regimen Optimization|01/31/2011| 31722073030|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 31722073090|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 31722073090|CE:DRO-IRBE150|Drug Regimen Optimization|01/31/2011| 31722073130|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 31722073190|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 31722073705|CE:DRO-DONEZ5|Drug Regimen Optimization|01/31/2011| 31722073730|CE:DRO-DONEZ5|Drug Regimen Optimization|01/31/2011| 31722073790|CE:DRO-DONEZ5|Drug Regimen Optimization|01/31/2011| 31722074530|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 31722074690|CE:DRO-VALSA80|Drug Regimen Optimization|01/31/2011| 31722074690|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 31722074790|CE:DRO-VALSA160|Drug Regimen Optimization|01/31/2011| 31722074790|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 31722074890|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 31722077605|CE:SDF-REVATIO|Sildenafil (Revatio)|01/31/2011| 31722077690|CE:SDF-REVATIO|Sildenafil (Revatio)|01/31/2011| 31722081930|CE:APY-ARI|Antipsychotics|04/10/2016| 31722082030|CE:APY-ARI|Antipsychotics|04/10/2016| 31722082030|CE:DRO-ARIPI5|Drug Regimen Optimization|01/31/2011| 31722082111|CE:VMAT-TET|VMAT2 Inhibitors|09/25/2018| 31722082211|CE:VMAT-TET|VMAT2 Inhibitors|09/25/2018| 31722082730|CE:APY-ARI|Antipsychotics|04/10/2016| 31722082730|CE:DRO-ARIPI10|Drug Regimen Optimization|01/31/2011| 31722082830|CE:APY-ARI|Antipsychotics|04/10/2016| 31722082830|CE:DRO-ARIPI15|Drug Regimen Optimization|01/31/2011| 31722082930|CE:APY-ARI|Antipsychotics|04/10/2016| 31722083030|CE:APY-ARI|Antipsychotics|04/10/2016| 31722088290|CE:DUP-STN|Duplicate Therapy|02/04/2016| 31722088290|CE:DRO-ROSUV5|Drug Regimen Optimization|01/31/2011| 31722088390|CE:DRO-ROSUV10|Drug Regimen Optimization|01/31/2011| 31722088390|CE:DUP-STN|Duplicate Therapy|02/04/2016| 31722088490|CE:DUP-STN|Duplicate Therapy|02/04/2016| 31722088490|CE:DRO-ROSUV20|Drug Regimen Optimization|01/31/2011| 31722088530|CE:DUP-STN|Duplicate Therapy|02/04/2016| 31722091701|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722091701|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722091701|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 31722091701|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 31722091705|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 31722091705|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722091705|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 31722091705|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722091801|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722091801|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 31722091801|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 31722091801|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722091805|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 31722091805|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 31722091805|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722091805|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722092601|CE:ADD-IRMETHYL|ADD/ADHD Agents|02/13/2014| 31722092701|CE:ADD-IRMETHYL|ADD/ADHD Agents|02/13/2014| 31722092801|CE:ADD-IRMETHYL|ADD/ADHD Agents|02/13/2014| 31722092901|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 31722092901|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 31722092901|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722092901|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722093001|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 31722093001|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722093001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722093001|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 31722093612|CE:LVZ-LOVAZ|Lovaza|07/16/2012| 31722094101|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 31722094101|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722094101|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 31722094101|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722094105|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722094105|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 31722094105|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722094105|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 31722094201|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722094201|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 31722094201|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 31722094201|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722094205|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722094205|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 31722094205|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722094205|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 31722094301|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 31722094301|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722094301|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722094301|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 31722094305|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 31722094305|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722094305|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722094305|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 31722094601|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722094601|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 31722094601|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722094601|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 31722094701|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722094701|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 31722094701|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722094701|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 31722094701|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 31722094801|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 31722094801|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722094801|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722094801|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 31722094901|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 31722094901|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 31722094901|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722094901|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722095005|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 31722095005|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 31722095005|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722095005|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722095101|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 31722095101|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 31722095101|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722095101|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722095105|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 31722095105|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722095105|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 31722095105|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 31722095201|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 31722095201|CE:DRO-MPHER18|Drug Regimen Optimization|01/31/2011| 31722095301|CE:DRO-MPHER27|Drug Regimen Optimization|01/31/2011| 31722095301|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 31722095401|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 31722095501|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 31722095801|CE:CCC-CCCC|Cough and Cold Agents - Clinical|12/15/2015| 33342001510|CE:DRO-AMLOD5|Drug Regimen Optimization|01/31/2011| 33342002707|CE:DRO-DONEZ5|Drug Regimen Optimization|01/31/2011| 33342002710|CE:DRO-DONEZ5|Drug Regimen Optimization|01/31/2011| 33342002715|CE:DRO-DONEZ5|Drug Regimen Optimization|01/31/2011| 33342002907|CE:DRO-DONEODT5|Drug Regimen Optimization|01/31/2011| 33342002960|CE:DRO-DONEODT5|Drug Regimen Optimization|01/31/2011| 33342003611|CE:DRO-ETP5|Drug Regimen Optimization|01/31/2011| 33342003711|CE:DRO-ETP10|Drug Regimen Optimization|01/31/2011| 33342004707|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342004707|CE:DRO-IRBE75|Drug Regimen Optimization|01/31/2011| 33342004710|CE:DRO-IRBE75|Drug Regimen Optimization|01/31/2011| 33342004710|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342004807|CE:DRO-IRBE150|Drug Regimen Optimization|01/31/2011| 33342004807|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342004810|CE:DRO-IRBE150|Drug Regimen Optimization|01/31/2011| 33342004810|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342004907|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342004910|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342005407|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 33342005410|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 33342005415|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 33342005507|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 33342005510|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 33342005515|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 33342005607|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 33342005610|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 33342005615|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 33342005707|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342005707|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 33342005710|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 33342005710|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342005807|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342005807|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 33342005810|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342005810|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 33342006207|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342006310|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342006310|CE:DRO-VALSA80|Drug Regimen Optimization|01/31/2011| 33342006410|CE:DRO-VALSA160|Drug Regimen Optimization|01/31/2011| 33342006410|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342006510|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342006707|CE:DRO-OLANZ2.5|Drug Regimen Optimization|01/31/2011| 33342006707|CE:APY-SGA|Antipsychotics|04/10/2016| 33342006744|CE:APY-SGA|Antipsychotics|04/10/2016| 33342006744|CE:DRO-OLANZ2.5|Drug Regimen Optimization|01/31/2011| 33342006807|CE:APY-SGA|Antipsychotics|04/10/2016| 33342006807|CE:DRO-OLANZ5|Drug Regimen Optimization|01/31/2011| 33342006844|CE:DRO-OLANZ5|Drug Regimen Optimization|01/31/2011| 33342006844|CE:APY-SGA|Antipsychotics|04/10/2016| 33342006907|CE:DRO-OLANZ7.5|Drug Regimen Optimization|01/31/2011| 33342006907|CE:APY-SGA|Antipsychotics|04/10/2016| 33342006944|CE:DRO-OLANZ7.5|Drug Regimen Optimization|01/31/2011| 33342006944|CE:APY-SGA|Antipsychotics|04/10/2016| 33342007007|CE:APY-SGA|Antipsychotics|04/10/2016| 33342007007|CE:DRO-OLANZ10|Drug Regimen Optimization|01/31/2011| 33342007015|CE:DRO-OLANZ10|Drug Regimen Optimization|01/31/2011| 33342007015|CE:APY-SGA|Antipsychotics|04/10/2016| 33342007107|CE:APY-SGA|Antipsychotics|04/10/2016| 33342007115|CE:APY-SGA|Antipsychotics|04/10/2016| 33342007207|CE:APY-SGA|Antipsychotics|04/10/2016| 33342007215|CE:APY-SGA|Antipsychotics|04/10/2016| 33342007410|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342007410|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 33342007444|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 33342007444|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342007510|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 33342007510|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342007515|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 33342007515|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342007610|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342007610|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 33342007615|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342007615|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 33342007710|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 33342007710|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342007715|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342007715|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 33342007810|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342007810|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 33342007815|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 33342007815|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342008307|CE:APY-SGA|Antipsychotics|04/10/2016| 33342008307|CE:DRO-OLAODT5|Drug Regimen Optimization|01/31/2011| 33342008311|CE:DRO-OLAODT5|Drug Regimen Optimization|01/31/2011| 33342008311|CE:APY-SGA|Antipsychotics|04/10/2016| 33342008407|CE:APY-SGA|Antipsychotics|04/10/2016| 33342008407|CE:DRO-OLAODT10|Drug Regimen Optimization|01/31/2011| 33342008411|CE:APY-SGA|Antipsychotics|04/10/2016| 33342008411|CE:DRO-OLAODT10|Drug Regimen Optimization|01/31/2011| 33342008507|CE:APY-SGA|Antipsychotics|04/10/2016| 33342008511|CE:APY-SGA|Antipsychotics|04/10/2016| 33342008607|CE:APY-SGA|Antipsychotics|04/10/2016| 33342008611|CE:APY-SGA|Antipsychotics|04/10/2016| 33342009911|CE:APY-SGA|Antipsychotics|04/10/2016| 33342010011|CE:APY-SGA|Antipsychotics|04/10/2016| 33342010111|CE:APY-SGA|Antipsychotics|04/10/2016| 33342010207|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 33342010210|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 33342010215|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 33342010311|CE:APY-SGA|Antipsychotics|04/10/2016| 33342010511|CE:APY-SGA|Antipsychotics|04/10/2016| 33342011007|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 33342011010|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 33342011107|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 33342011110|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 33342011407|CE:DRO-CARD4|Drug Regimen Optimization|01/31/2011| 33342011407|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342011507|CE:DRO-CARD8|Drug Regimen Optimization|01/31/2011| 33342011507|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342011607|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342011607|CE:DRO-CARD16|Drug Regimen Optimization|01/31/2011| 33342011610|CE:DRO-CARD16|Drug Regimen Optimization|01/31/2011| 33342011610|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342011707|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342011710|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342012110|CE:SDF-REVATIO|Sildenafil (Revatio)|01/31/2011| 33342012207|CE:APY-ARI|Antipsychotics|04/10/2016| 33342012307|CE:DRO-ARIPI5|Drug Regimen Optimization|01/31/2011| 33342012307|CE:APY-ARI|Antipsychotics|04/10/2016| 33342012407|CE:APY-ARI|Antipsychotics|04/10/2016| 33342012407|CE:DRO-ARIPI10|Drug Regimen Optimization|01/31/2011| 33342012507|CE:DRO-ARIPI15|Drug Regimen Optimization|01/31/2011| 33342012507|CE:APY-ARI|Antipsychotics|04/10/2016| 33342012607|CE:APY-ARI|Antipsychotics|04/10/2016| 33342012707|CE:APY-ARI|Antipsychotics|04/10/2016| 33342013110|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 33342013110|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342013115|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 33342013115|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342013210|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342013210|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 33342013215|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342013215|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 33342013310|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342013310|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 33342013315|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 33342013315|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342014409|CE:APY-SGA|Antipsychotics|04/10/2016| 33342014509|CE:APY-SGA|Antipsychotics|04/10/2016| 33342014609|CE:APY-SGA|Antipsychotics|04/10/2016| 33342014709|CE:APY-SGA|Antipsychotics|04/10/2016| 33342015509|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 33342015509|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 33342015711|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 33342015711|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 33342015715|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 33342015715|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 33342015809|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 33342015809|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 33342017609|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 33342017657|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 33342017709|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 33342017757|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 33342017807|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342017907|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342017907|CE:DRO-OLMES20|Drug Regimen Optimization|01/31/2011| 33342017910|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342017910|CE:DRO-OLMES20|Drug Regimen Optimization|01/31/2011| 33342018007|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342018010|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342019007|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342019010|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342019107|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342019110|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342019207|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342019210|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342019307|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342019310|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 33342020010|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 33342020144|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 33342020144|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 33342020144|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 33342020144|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 33342027607|CE:DRO-DARI7.5|Drug Regimen Optimization|01/31/2011| 33342029907|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 33342030011|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 33342030111|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 35356055630|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 35356055630|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 35356055630|CE:STX-STX|Subutex (buprenorphine)|12/05/2014| 35573041302|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 35573041302|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 35573041304|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 35573041304|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 35573041402|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 35573041402|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 35573041404|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 35573041404|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 35573041530|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 35573041630|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 35573041730|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 35573041830|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 35573041930|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 35573042030|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 35573042130|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 39328004416|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 41616075981|CE:DRO-VENL75|Drug Regimen Optimization|01/31/2011| 41616075983|CE:DRO-VENL75|Drug Regimen Optimization|01/31/2011| 41616076081|CE:DRO-VENL37.5|Drug Regimen Optimization|01/31/2011| 41616076083|CE:DRO-VENL37.5|Drug Regimen Optimization|01/31/2011| 42023011001|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 42023011101|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 42023011201|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 42043016001|CE:MOD-MOD|Modafinil (Provigil)|11/06/2012| 42043016001|CE:MOD-MOD|Modafinil (Provigil)|11/08/2012| 42043016003|CE:MOD-MOD|Modafinil (Provigil)|11/08/2012| 42043016003|CE:MOD-MOD|Modafinil (Provigil)|11/06/2012| 42043016101|CE:MOD-MOD|Modafinil (Provigil)|11/08/2012| 42043016101|CE:MOD-MOD|Modafinil (Provigil)|11/06/2012| 42043016103|CE:MOD-MOD|Modafinil (Provigil)|11/06/2012| 42043016103|CE:MOD-MOD|Modafinil (Provigil)|11/08/2012| 42043016190|CE:MOD-MOD|Modafinil (Provigil)|11/06/2012| 42043016190|CE:MOD-MOD|Modafinil (Provigil)|11/08/2012| 42043021001|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 42043021101|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 42043032003|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 42043032101|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 42043032201|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 42043039002|CE:AEM-ANTIEME|Antiemetics Oral|01/31/2011| 42043039020|CE:AEM-ANTIEME|Antiemetics Oral|01/31/2011| 42043039021|CE:AEM-ANTIEME|Antiemetics Oral|01/31/2011| 42043040003|CE:APY-ARI|Antipsychotics|04/10/2016| 42043040103|CE:APY-ARI|Antipsychotics|04/10/2016| 42192060704|CE:DXO-DEXQ|Dextromethorphan Overutilization|07/16/2012| 42192060704|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 42192060704|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 42192060716|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 42192060716|CE:DXO-DEXQ|Dextromethorphan Overutilization|07/16/2012| 42192060716|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 42192060816|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 42195010090|CE:DUP-NSD|Duplicate Therapy|02/05/2013|08/05/2030 42195012106|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 42195012106|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 42195015110|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 42195015110|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 42195030809|CE:DUP-NSD|Duplicate Therapy|02/05/2013|12/05/2030 42195047101|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 42195084010|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020|08/15/2045 42195084010|CE:OPO-OOVU|Opiate Overutilization|11/05/2013|08/15/2045 42195084010|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|08/15/2045 42195084010|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|08/15/2045 42291017430|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42291017430|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42291017430|CE:SUB-SUBOX|Suboxone|04/23/2013| 42291017530|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42291017530|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42291017530|CE:SUB-SUBOX|Suboxone|04/23/2013| 42292000916|CE:DRO-EMP20|Drug Regimen Optimization|01/31/2011| 42292002620|CE:APY-SGA|Antipsychotics|04/10/2016| 42292002720|CE:APY-SGA|Antipsychotics|04/10/2016| 42494040901|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42494040901|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42494040901|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42543000510|CE:SDF-REVATIO|Sildenafil (Revatio)|01/31/2011| 42543000590|CE:SDF-REVATIO|Sildenafil (Revatio)|01/31/2011| 42543011401|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 42543011501|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 42543014050|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 42543014050|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 42543014101|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 42543014101|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 42543014201|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 42543014201|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 42543043401|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42543043401|CE:CCA-LDCARIS|Carisoprodol Containing Agents|01/31/2011| 42543043401|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42543070001|CE:CCA-LDCARIS|Carisoprodol Containing Agents|01/31/2011| 42543070001|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42543070001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42543070005|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42543070005|CE:CCA-LDCARIS|Carisoprodol Containing Agents|01/31/2011| 42543070005|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42543070010|CE:CCA-LDCARIS|Carisoprodol Containing Agents|01/31/2011| 42543070010|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42543070010|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42543070205|CE:DRO-DONEZ5|Drug Regimen Optimization|01/31/2011| 42543070210|CE:DRO-DONEZ5|Drug Regimen Optimization|01/31/2011| 42543070230|CE:DRO-DONEZ5|Drug Regimen Optimization|01/31/2011| 42543070290|CE:DRO-DONEZ5|Drug Regimen Optimization|01/31/2011| 42543071290|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 42571011010|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 42571011010|CE:DRO-LORSA25|Drug Regimen Optimization|01/31/2011| 42571011110|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 42571011110|CE:DRO-LORSA50|Drug Regimen Optimization|01/31/2011| 42571011210|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 42571011901|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42571011901|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42571011901|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 42571011901|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42571011905|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 42571011905|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42571011905|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42571011905|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42571012290|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 42571014260|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 42571014260|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 42571014301|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 42571014301|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 42571014305|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 42571014305|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 42571014401|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 42571014401|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 42571014405|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 42571014405|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 42571014560|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 42571014560|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 42571017601|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 42571017701|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 42571022630|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 42571022630|CE:DRO-TELMI20|Drug Regimen Optimization|01/31/2011| 42571022730|CE:DRO-TELMI40|Drug Regimen Optimization|01/31/2011| 42571022730|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 42571022830|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 42571023530|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 42571023590|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 42571023630|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 42571023690|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 42571023730|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 42571023790|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 42571023830|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 42571023890|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 42571025830|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 42747072601|CE:AEM-ANTIEME|Antiemetics Oral|01/31/2011| 42799011101|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 42799011201|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 42799021701|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42799021701|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42799021701|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 42799021702|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42799021702|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 42799021702|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42799081201|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 42799081201|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 42799081301|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 42799081301|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 42806000501|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 42806000501|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42806000501|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42806000501|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42806000601|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42806000601|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42806000601|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 42806000601|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42806000701|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42806000701|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 42806000701|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42806000701|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42806000801|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42806000801|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42806000801|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 42806000801|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42806000901|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 42806000901|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42806000901|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42806000901|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42806001101|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 42806001105|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 42806001201|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 42806001210|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 42806001401|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 42806001410|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 42806001801|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 42806001805|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 42806001901|CE:DRO-CTP10|Drug Regimen Optimization|01/31/2011| 42806001910|CE:DRO-CTP10|Drug Regimen Optimization|01/31/2011| 42806002001|CE:DRO-CTP20|Drug Regimen Optimization|01/31/2011| 42806002010|CE:DRO-CTP20|Drug Regimen Optimization|01/31/2011| 42806005505|CE:DRO-AMLOD2.5|Drug Regimen Optimization|01/31/2011| 42806005509|CE:DRO-AMLOD2.5|Drug Regimen Optimization|01/31/2011| 42806005510|CE:DRO-AMLOD2.5|Drug Regimen Optimization|01/31/2011| 42806005605|CE:DRO-AMLOD5|Drug Regimen Optimization|01/31/2011| 42806005609|CE:DRO-AMLOD5|Drug Regimen Optimization|01/31/2011| 42806005610|CE:DRO-AMLOD5|Drug Regimen Optimization|01/31/2011| 42806008701|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 42806008801|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 42806008901|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 42806015901|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 42806015905|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 42806015910|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 42806016001|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 42806016005|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 42806016010|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 42806016101|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 42806016105|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 42806016110|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 42806033601|CE:APY-FGA|Antipsychotics|04/10/2016| 42806033701|CE:APY-FGA|Antipsychotics|04/10/2016| 42806033801|CE:APY-FGA|Antipsychotics|04/10/2016| 42806033901|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 42806034101|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 42806034301|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 42806034401|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 42806034501|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 42806034805|CE:DRO-BUPR150|Drug Regimen Optimization|01/31/2011| 42806034809|CE:DRO-BUPR150|Drug Regimen Optimization|01/31/2011| 42806034830|CE:DRO-BUPR150|Drug Regimen Optimization|01/31/2011| 42806040001|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 42806040001|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 42806055212|CE:LVZ-LOVAZ|Lovaza|07/16/2012| 42806064801|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 42806064810|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 42806064901|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 42806064910|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 42806071401|CE:CCC-CCCC|Cough and Cold Agents - Clinical|12/15/2015| 42806071405|CE:CCC-CCCC|Cough and Cold Agents - Clinical|12/15/2015| 42806071501|CE:CCC-CCCC|Cough and Cold Agents - Clinical|12/15/2015| 42806071505|CE:CCC-CCCC|Cough and Cold Agents - Clinical|12/15/2015| 42858000101|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 42858000101|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42858000101|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858000101|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858000201|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42858000201|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 42858000201|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858000201|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858000301|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42858000301|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 42858000301|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858000301|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858000401|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858000401|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 42858000401|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42858000401|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858000501|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858000501|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858000501|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 42858000501|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42858001101|CE:ADD-IRFOC|ADD/ADHD Agents|02/13/2014| 42858004001|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 42858004001|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42858004001|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858004001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858005501|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 42858005501|CE:DRO-APHXL5|Drug Regimen Optimization|01/31/2011| 42858007545|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 42858007645|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 42858007745|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 42858007845|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 42858007945|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 42858008045|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 42858008145|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 42858010201|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 42858010201|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42858010201|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858010201|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858010250|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 42858010250|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42858010250|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858010250|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858010301|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42858010301|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858010301|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858010301|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 42858010350|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42858010350|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 42858010350|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858010350|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858010401|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 42858010401|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858010401|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42858010401|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858010450|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858010450|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858010450|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42858010450|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 42858012201|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 42858012201|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858012201|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858012201|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42858013901|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42858013901|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858013901|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 42858013901|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858020101|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42858020101|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858020101|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 42858020101|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858020150|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 42858020150|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858020150|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42858020150|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858020201|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42858020201|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858020201|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 42858020201|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858020301|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42858020301|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 42858020301|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858020301|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858020350|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 42858020350|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42858020350|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858020350|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858021501|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 42858021501|CE:DRO-APHXK15|Drug Regimen Optimization|01/31/2011| 42858022501|CE:ADD-IRFOC|ADD/ADHD Agents|02/13/2014| 42858023401|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 42858023401|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858023401|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42858023401|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858023450|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42858023450|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858023450|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858023450|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 42858023801|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42858023801|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 42858023801|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858023801|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858030101|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858030101|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42858030101|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 42858030101|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858030201|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858030201|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 42858030201|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858030201|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42858030250|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858030250|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42858030250|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 42858030250|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858030301|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 42858030301|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42858030301|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858030301|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858030416|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 42858030416|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42858030416|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858030416|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858032501|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 42858033801|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858033801|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42858033801|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858033801|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 42858035340|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 42858035340|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858035340|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858040145|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 42858040245|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 42858040345|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 42858040445|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 42858040545|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 42858040645|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 42858040745|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 42858041001|CE:ADD-IRFOC|ADD/ADHD Agents|02/13/2014| 42858041616|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858041616|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42858041616|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 42858041616|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858049340|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858049340|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42858049340|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 42858049340|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858050103|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858050103|CE:STX-STX|Subutex (buprenorphine)|12/05/2014| 42858050103|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858050203|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858050203|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858050203|CE:STX-STX|Subutex (buprenorphine)|12/05/2014| 42858051501|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858051501|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 42858051501|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858051501|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42858058640|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858058640|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 42858058640|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858061001|CE:DRO-APHXL10|Drug Regimen Optimization|01/31/2011| 42858061001|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 42858063101|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858063101|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858063101|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 42858063101|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42858070101|CE:DUP-MLX|Duplicate Therapy|02/05/2013| 42858070201|CE:DUP-MLX|Duplicate Therapy|02/05/2013| 42858070303|CE:DRO-PRX12.5|Drug Regimen Optimization|01/31/2011| 42858072001|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 42858075040|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858075040|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42858075040|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858075040|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 42858076001|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 42858076001|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858076001|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42858076001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858079901|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858079901|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 42858079901|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42858079901|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858080101|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42858080101|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858080101|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858080101|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 42858080201|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42858080201|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858080201|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858080201|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 42858080301|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858080301|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858080301|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 42858080301|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42858080401|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858080401|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42858080401|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858080401|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 42858080501|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 42858080501|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858080501|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858080501|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42858083940|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858083940|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858083940|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 42858083940|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42858090001|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 42858090001|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 42858090001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858090001|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 42858093001|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 43068010102|CE:APY-SGA|Antipsychotics|04/10/2016| 43068010202|CE:APY-SGA|Antipsychotics|04/10/2016| 43068010402|CE:APY-SGA|Antipsychotics|04/10/2016| 43068010602|CE:APY-SGA|Antipsychotics|04/10/2016| 43068010802|CE:APY-SGA|Antipsychotics|04/10/2016| 43068011002|CE:APY-SGA|Antipsychotics|04/10/2016| 43068011202|CE:APY-SGA|Antipsychotics|04/10/2016| 43068011304|CE:APY-SGA|Antipsychotics|04/10/2016| 43386011801|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386011801|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 43386011801|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386011801|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 43386011803|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386011803|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 43386011803|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 43386011803|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386035101|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 43386035101|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386035101|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 43386035101|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386035105|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 43386035105|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 43386035105|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386035105|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386035201|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386035201|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386035201|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 43386035201|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 43386035205|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386035205|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386035205|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 43386035205|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 43386035301|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 43386035301|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386035301|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 43386035301|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386035305|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386035305|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 43386035305|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386035305|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 43386035601|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386035601|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 43386035601|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386035601|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 43386035610|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 43386035610|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386035610|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386035610|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 43386035701|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 43386035701|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386035701|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386035701|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 43386035801|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 43386035801|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386035801|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386035801|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 43386035810|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 43386035810|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386035810|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386035810|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 43386043001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386043001|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 43386043001|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 43386043001|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386043101|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 43386043101|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386043101|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386043101|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 43386043201|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 43386043201|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386043201|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 43386043201|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386043301|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386043301|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 43386043301|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386043301|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 43386043401|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386043401|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 43386043401|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 43386043401|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386048024|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386048024|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386048026|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386048026|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386048028|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386048028|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386054001|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 43386054001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386054001|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 43386054001|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386054101|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 43386054101|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 43386054101|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386054101|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386054201|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 43386054201|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386054201|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 43386054201|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386054301|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386054301|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 43386054301|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 43386054301|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386054401|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386054401|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 43386054401|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386054401|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 43386057001|CE:ADD-IRMETHYL|ADD/ADHD Agents|02/13/2014| 43386057101|CE:ADD-IRMETHYL|ADD/ADHD Agents|02/13/2014| 43386057201|CE:ADD-IRMETHYL|ADD/ADHD Agents|02/13/2014| 43386057301|CE:ADD-IRMETHYL|ADD/ADHD Agents|02/13/2014| 43386057401|CE:ADD-IRMETHYL|ADD/ADHD Agents|02/13/2014| 43386057501|CE:ADD-IRMETHYL|ADD/ADHD Agents|02/13/2014| 43386068001|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386068001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386068001|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 43386068001|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 43386071005|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013|02/20/2021 43386071009|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013|02/20/2021 43386071105|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013|02/20/2021 43386071109|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013|02/20/2021 43386071205|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013|02/20/2021 43386071209|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013|02/20/2021 43386076130|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 43386076230|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 43386086001|CE:ADD-IRFOC|ADD/ADHD Agents|02/13/2014| 43386086101|CE:ADD-IRFOC|ADD/ADHD Agents|02/13/2014| 43386086201|CE:ADD-IRFOC|ADD/ADHD Agents|02/13/2014| 43386087001|CE:ADD-IRZen|ADD/ADHD Agents|02/13/2014| 43386087101|CE:ADD-IRZen|ADD/ADHD Agents|02/13/2014| 43386092060|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 43386092060|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43386092060|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43547022610|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43547022610|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43547022650|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43547022650|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43547025110|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43547025110|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43547025110|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43547025110|CE:ASH-CMOXAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 43547025210|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43547025210|CE:ASH-CMOXAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 43547025210|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43547025210|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43547025310|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43547025310|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43547025310|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43547025310|CE:ASH-CMOXAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 43547026510|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 43547026550|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 43547026610|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 43547026650|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 43547026710|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 43547026750|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 43547027503|CE:DRO-DONEZ5|Drug Regimen Optimization|01/31/2011| 43547027509|CE:DRO-DONEZ5|Drug Regimen Optimization|01/31/2011| 43547027511|CE:DRO-DONEZ5|Drug Regimen Optimization|01/31/2011| 43547027703|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 43547027703|CE:DRO-IRBE75|Drug Regimen Optimization|01/31/2011| 43547028010|CE:DRO-ETP5|Drug Regimen Optimization|01/31/2011| 43547028011|CE:DRO-ETP5|Drug Regimen Optimization|01/31/2011| 43547028110|CE:DRO-ETP10|Drug Regimen Optimization|01/31/2011| 43547028111|CE:DRO-ETP10|Drug Regimen Optimization|01/31/2011| 43547030203|CE:APY-ARI|Antipsychotics|04/10/2016| 43547030303|CE:DRO-ARIPI5|Drug Regimen Optimization|01/31/2011| 43547030303|CE:APY-ARI|Antipsychotics|04/10/2016| 43547030403|CE:APY-ARI|Antipsychotics|04/10/2016| 43547030403|CE:DRO-ARIPI10|Drug Regimen Optimization|01/31/2011| 43547030503|CE:DRO-ARIPI15|Drug Regimen Optimization|01/31/2011| 43547030503|CE:APY-ARI|Antipsychotics|04/10/2016| 43547030603|CE:APY-ARI|Antipsychotics|04/10/2016| 43547030703|CE:APY-ARI|Antipsychotics|04/10/2016| 43547033003|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 43547033003|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 43547033009|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 43547033009|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 43547033103|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 43547033103|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 43547033109|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 43547033109|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 43547033906|CE:APY-ARI|Antipsychotics|04/10/2016| 43547033906|CE:DRO-RISP0.25|Drug Regimen Optimization|01/31/2011| 43547033950|CE:DRO-RISP0.25|Drug Regimen Optimization|01/31/2011| 43547033950|CE:APY-ARI|Antipsychotics|04/10/2016| 43547034006|CE:APY-ARI|Antipsychotics|04/10/2016| 43547034006|CE:DRO-RISP0.5|Drug Regimen Optimization|01/31/2011| 43547034050|CE:DRO-RISP0.5|Drug Regimen Optimization|01/31/2011| 43547034050|CE:APY-ARI|Antipsychotics|04/10/2016| 43547034106|CE:APY-ARI|Antipsychotics|04/10/2016| 43547034106|CE:DRO-RISP1|Drug Regimen Optimization|01/31/2011| 43547034150|CE:APY-ARI|Antipsychotics|04/10/2016| 43547034150|CE:DRO-RISP1|Drug Regimen Optimization|01/31/2011| 43547034206|CE:APY-ARI|Antipsychotics|04/10/2016| 43547034206|CE:DRO-RISP2|Drug Regimen Optimization|01/31/2011| 43547034250|CE:DRO-RISP2|Drug Regimen Optimization|01/31/2011| 43547034250|CE:APY-ARI|Antipsychotics|04/10/2016| 43547034306|CE:APY-ARI|Antipsychotics|04/10/2016| 43547034350|CE:APY-ARI|Antipsychotics|04/10/2016| 43547034406|CE:APY-ARI|Antipsychotics|04/10/2016| 43547034450|CE:APY-ARI|Antipsychotics|04/10/2016| 43547034703|CE:DRO-PRX10|Drug Regimen Optimization|01/31/2011| 43547034709|CE:DRO-PRX10|Drug Regimen Optimization|01/31/2011| 43547034711|CE:DRO-PRX10|Drug Regimen Optimization|01/31/2011| 43547034750|CE:DRO-PRX10|Drug Regimen Optimization|01/31/2011| 43547034803|CE:DRO-PRX20|Drug Regimen Optimization|01/31/2011| 43547034809|CE:DRO-PRX20|Drug Regimen Optimization|01/31/2011| 43547034811|CE:DRO-PRX20|Drug Regimen Optimization|01/31/2011| 43547034850|CE:DRO-PRX20|Drug Regimen Optimization|01/31/2011| 43547036009|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 43547036009|CE:DRO-LORSA25|Drug Regimen Optimization|01/31/2011| 43547036050|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 43547036050|CE:DRO-LORSA25|Drug Regimen Optimization|01/31/2011| 43547036103|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 43547036103|CE:DRO-LORSA50|Drug Regimen Optimization|01/31/2011| 43547036109|CE:DRO-LORSA50|Drug Regimen Optimization|01/31/2011| 43547036109|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 43547036111|CE:DRO-LORSA50|Drug Regimen Optimization|01/31/2011| 43547036111|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 43547036203|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 43547036211|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 43547037310|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43547037310|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43547037310|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 43547037310|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 43547037409|CE:DRO-IRBE75|Drug Regimen Optimization|01/31/2011| 43547037409|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 43547037509|CE:DRO-IRBE150|Drug Regimen Optimization|01/31/2011| 43547037509|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 43547037550|CE:DRO-IRBE150|Drug Regimen Optimization|01/31/2011| 43547037550|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 43547038450|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 43547038510|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 43547038550|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 43547038609|CE:DRO-FOSI10|Drug Regimen Optimization|01/31/2011| 43547038709|CE:DRO-FOSI20|Drug Regimen Optimization|01/31/2011| 43547038950|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 43547039050|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 43547039103|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 43547039103|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 43547039109|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 43547039109|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 43547039203|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 43547039203|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 43547039209|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 43547039209|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 43547039303|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 43547039303|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 43547039309|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 43547039309|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 43547039710|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 43547039711|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 43547039810|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 43547039811|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 43547039910|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43547039910|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43547039910|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011| 43547039950|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43547039950|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43547039950|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011| 43547040010|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43547040010|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43547040010|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011| 43547040011|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43547040011|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43547040011|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011| 43547040050|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011| 43547040050|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43547040050|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43547040510|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43547040510|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43547040610|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 43547040610|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43547040610|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43547040610|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43547040611|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 43547040611|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43547040611|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43547040611|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43547040711|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43547040711|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43547040711|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 43547040711|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43547040810|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43547040810|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 43547040810|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43547040810|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43547040850|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43547040850|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43547040850|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 43547040850|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43547042010|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 43547042050|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 43547042110|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 43547042150|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 43547042210|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 43547042250|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 43547043506|CE:ADD-KAPVAY|ADD/ADHD Agents|02/13/2014| 43547044103|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 43547044103|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 43547044203|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 43547044203|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 43547044303|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 43547044303|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 43598016405|CE:APY-SGA|Antipsychotics|04/10/2016| 43598016405|CE:DRO-OLANZ5|Drug Regimen Optimization|01/31/2011| 43598016430|CE:DRO-OLANZ5|Drug Regimen Optimization|01/31/2011| 43598016430|CE:APY-SGA|Antipsychotics|04/10/2016| 43598016505|CE:APY-SGA|Antipsychotics|04/10/2016| 43598016505|CE:DRO-OLANZ7.5|Drug Regimen Optimization|01/31/2011| 43598016530|CE:DRO-OLANZ7.5|Drug Regimen Optimization|01/31/2011| 43598016530|CE:APY-SGA|Antipsychotics|04/10/2016| 43598016605|CE:DRO-OLANZ10|Drug Regimen Optimization|01/31/2011| 43598016605|CE:APY-SGA|Antipsychotics|04/10/2016| 43598016630|CE:DRO-OLANZ10|Drug Regimen Optimization|01/31/2011| 43598016630|CE:APY-SGA|Antipsychotics|04/10/2016| 43598031330|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 43598031430|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 43598031530|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 43598031590|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 43598031630|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 43598031690|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 43598031730|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 43598031830|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 43598031890|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 43598031930|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 43598031990|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 43598032030|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 43598032130|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 43598032190|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 43598032230|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 43598032290|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 43598032330|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 43598039467|CE:VMAT-TET|VMAT2 Inhibitors|09/25/2018| 43598039567|CE:VMAT-TET|VMAT2 Inhibitors|09/25/2018| 43598040727|CE:DRO-EMP20|Drug Regimen Optimization|01/31/2011| 43598040733|CE:DRO-EMP20|Drug Regimen Optimization|01/31/2011| 43598040752|CE:DRO-EMP20|Drug Regimen Optimization|01/31/2011| 43598043801|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 43598043801|CE:DRO-MPHER18|Drug Regimen Optimization|01/31/2011| 43598043901|CE:DRO-MPHER27|Drug Regimen Optimization|01/31/2011| 43598043901|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 43598044001|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 43598044101|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 43598049401|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 43598049501|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 43598049505|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 43598050501|CE:DUP-RXF|Duplicate Therapy|02/04/2016| 43598050510|CE:DUP-RXF|Duplicate Therapy|02/04/2016| 43598050530|CE:DUP-RXF|Duplicate Therapy|02/04/2016| 43598050910|CE:DRO-EMP20|Drug Regimen Optimization|01/31/2011| 43598050930|CE:DRO-EMP20|Drug Regimen Optimization|01/31/2011| 43598050990|CE:DRO-EMP20|Drug Regimen Optimization|01/31/2011| 43598055430|CE:APY-ARI|Antipsychotics|04/10/2016| 43598055530|CE:APY-ARI|Antipsychotics|04/10/2016| 43598055530|CE:DRO-ARIPI5|Drug Regimen Optimization|01/31/2011| 43598055630|CE:DRO-ARIPI10|Drug Regimen Optimization|01/31/2011| 43598055630|CE:APY-ARI|Antipsychotics|04/10/2016| 43598055730|CE:APY-ARI|Antipsychotics|04/10/2016| 43598055730|CE:DRO-ARIPI15|Drug Regimen Optimization|01/31/2011| 43598055830|CE:APY-ARI|Antipsychotics|04/10/2016| 43598055930|CE:APY-ARI|Antipsychotics|04/10/2016| 43598057860|CE:SDF-REVATIO|Sildenafil (Revatio)|01/31/2011| 43598057901|CE:SUB-SUBOX|Suboxone|04/23/2013| 43598057901|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43598057901|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43598057930|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43598057930|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43598057930|CE:SUB-SUBOX|Suboxone|04/23/2013| 43598058001|CE:SUB-SUBOX|Suboxone|04/23/2013| 43598058001|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43598058001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43598058030|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43598058030|CE:SUB-SUBOX|Suboxone|04/23/2013| 43598058030|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43598058101|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43598058101|CE:SUB-SUBOX|Suboxone|04/23/2013| 43598058101|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43598058130|CE:SUB-SUBOX|Suboxone|04/23/2013| 43598058130|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43598058130|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43598058201|CE:SUB-SUBOX|Suboxone|04/23/2013| 43598058201|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43598058201|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43598058230|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43598058230|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 43598058230|CE:SUB-SUBOX|Suboxone|04/23/2013| 43598058310|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 43598058330|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 43598058390|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 43598058410|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 43598058430|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 43598058490|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 43598058510|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 43598058530|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 43598058590|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 43598058610|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 43598058630|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 43598058690|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 43598065505|CE:DRO-BUPR150|Drug Regimen Optimization|01/31/2011| 43598065530|CE:DRO-BUPR150|Drug Regimen Optimization|01/31/2011| 43598073330|CE:APY-ARI|Antipsychotics|04/10/2016| 43598073430|CE:APY-ARI|Antipsychotics|04/10/2016| 43598073530|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013|08/31/2021 43598073590|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013|08/31/2021 43598074101|CE:ASH-RAMELT|Anxiolytics Sedatives and Hypnotics|01/31/2011| 43598074130|CE:ASH-RAMELT|Anxiolytics Sedatives and Hypnotics|01/31/2011| 43598074210|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 43598074230|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 43598074290|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 43598074305|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 43598074330|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 43598074390|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 43598074410|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 43598074430|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 43598074490|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 43598074530|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 43598074590|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 43598081112|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 43598081115|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 43598082314|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 43598082331|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 43598082335|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 43598084858|CE:APY-SGA|Antipsychotics|04/10/2016| 43598089701|CE:ADD-IREVT|ADD/ADHD Agents|12/18/2019| 43598089801|CE:ADD-IREVT|ADD/ADHD Agents|12/18/2019| 43975027710|CE:DRO-APHXL5|Drug Regimen Optimization|01/31/2011| 43975027710|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 43975027810|CE:DRO-APHXL10|Drug Regimen Optimization|01/31/2011| 43975027810|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 43975027910|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 43975027910|CE:DRO-APHXK15|Drug Regimen Optimization|01/31/2011| 43975028010|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 43975028110|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 43975028210|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 43975032203|CE:DRO-TOLTLA2|Drug Regimen Optimization|01/31/2011| 43975032209|CE:DRO-TOLTLA2|Drug Regimen Optimization|01/31/2011| 43975033110|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 43975033110|CE:DRO-APHXL5|Drug Regimen Optimization|01/31/2011| 43975033210|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 43975033210|CE:DRO-APHXL10|Drug Regimen Optimization|01/31/2011| 43975033310|CE:DRO-APHXK15|Drug Regimen Optimization|01/31/2011| 43975033310|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 43975033410|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 43975033510|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 43975033610|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 43975034903|CE:APY-SGA|Antipsychotics|04/10/2016| 43975035003|CE:APY-SGA|Antipsychotics|04/10/2016| 43975035103|CE:APY-SGA|Antipsychotics|04/10/2016| 43975035203|CE:APY-SGA|Antipsychotics|04/10/2016| 44087000407|CE:GRH-NPGROWTH|Growth Hormones|01/31/2011| 44087000407|CE:GRH-NP SERO|Growth Hormones|01/31/2011| 44087000507|CE:GRH-NPGROWTH|Growth Hormones|01/31/2011| 44087000507|CE:GRH-NP SERO|Growth Hormones|01/31/2011| 44087000607|CE:GRH-NP SERO|Growth Hormones|01/31/2011| 44087100502|CE:GRH-NPGROWTH|Growth Hormones|01/31/2011| 44087100502|CE:GRH-NP SERO|Growth Hormones|01/31/2011| 44087108801|CE:GRH-NP SERO|Growth Hormones|01/31/2011| 44087108801|CE:GRH-NPGROWTH|Growth Hormones|01/31/2011| 44087108801|CE:GRH-NP ZORB|Growth Hormones|01/31/2011| 44087338807|CE:GRH-NP ZORB|Growth Hormones|01/31/2011| 44087338807|CE:GRH-NPGROWTH|Growth Hormones|01/31/2011| 44087338807|CE:GRH-NP SERO|Growth Hormones|01/31/2011| 44523082501|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013|03/31/2021 45802002683|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 45802005705|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 45802008765|CE:DPP-ALG6|DPP-4 Inhibitors|09/25/2018| 45802008801|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 45802010365|CE:DPP-ALO12|DPP-4 Inhibitors|09/25/2018| 45802011101|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 45802012246|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 45802012260|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 45802012265|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 45802013326|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 45802014026|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 45802015065|CE:DPP-ALO25|DPP-4 Inhibitors|09/25/2018| 45802016000|CE:DUP-NSD|Duplicate Therapy|02/05/2013|03/01/2022 45802016972|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 45802021172|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 45802023068|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 45802023068|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 45802023089|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 45802023089|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 45802023865|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 45802024501|CE:DRO-LPZ15|Drug Regimen Optimization|01/31/2011| 45802024502|CE:DRO-LPZ15|Drug Regimen Optimization|01/31/2011| 45802024503|CE:DRO-LPZ15|Drug Regimen Optimization|01/31/2011| 45802026065|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 45802030465|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 45802035165|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 45802036853|CE:IMI-IMIQ5|Imiquimod|07/16/2012| 45802036862|CE:IMI-IMIQ5|Imiquimod|07/16/2012| 45802039000|CE:TIM-TIM|Topical Immunomodulators ( Elidel & Protopic)|01/31/2011| 45802039001|CE:TIM-TIM|Topical Immunomodulators ( Elidel & Protopic)|01/31/2011| 45802039002|CE:TIM-TIM|Topical Immunomodulators ( Elidel & Protopic)|01/31/2011| 45802040265|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 45802041059|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 45802042578|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 45802043321|CE:DXO-DEXI|Dextromethorphan Overutilization|07/16/2012| 45802043321|CE:CCC-CCCA|Cough and Cold Agents - Clinical|12/15/2015| 45802043321|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 45802049078|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 45802049965|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 45802057178|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 45802062626|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 45802065065|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 45802065078|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 45802065087|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 45802068028|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 45802070000|CE:TIM-PRO|Topical Immunomodulators ( Elidel & Protopic)|01/31/2011| 45802070001|CE:TIM-PRO|Topical Immunomodulators ( Elidel & Protopic)|01/31/2011| 45802070002|CE:TIM-PRO|Topical Immunomodulators ( Elidel & Protopic)|01/31/2011| 45802072153|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013|05/01/2022 45802072162|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013|03/12/2021 45802075830|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 45802075930|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 45802088830|CE:DRO-OMP20|Drug Regimen Optimization|01/31/2011| 45802088855|CE:DRO-OMP20|Drug Regimen Optimization|01/31/2011| 45802089726|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 45802089734|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 45802091939|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 45802091987|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 45802095226|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 45802095243|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 45802095301|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 45802097426|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 45963012523|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 45963012524|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 45963030309|CE:ADD-ERDEX|ADD/ADHD Agents|02/13/2014| 45963030409|CE:ADD-ERDEX|ADD/ADHD Agents|02/13/2014| 45963030509|CE:ADD-ERDEX|ADD/ADHD Agents|02/13/2014| 45963041806|CE:RAN-RAN|Ranolazine|05/25/2012| 45963041850|CE:RAN-RAN|Ranolazine|05/25/2012| 45963041906|CE:RAN-RAN|Ranolazine|05/25/2012| 45963041950|CE:RAN-RAN|Ranolazine|05/25/2012| 45963047903|CE:GIM-ALO|GI Motility|01/18/2017| 45963048003|CE:GIM-ALO|GI Motility|01/18/2017| 45963055511|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 45963055550|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 45963055611|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 45963055650|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 45963055711|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 45963055750|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 45963056508|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 45963056530|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 45963056608|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 45963056630|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 45963056708|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 45963056730|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 45963056808|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 45963056830|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 45963063504|CE:DUP-STN|Duplicate Therapy|02/04/2016|03/31/2021 46122001062|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 46122002903|CE:DRO-OMP20|Drug Regimen Optimization|01/31/2011| 46122002904|CE:DRO-OMP20|Drug Regimen Optimization|01/31/2011| 46122002974|CE:DRO-OMP20|Drug Regimen Optimization|01/31/2011| 47335017795|CE:CYC-ILU|Cytokine and CAM Antagonists|06/25/2019| 47335017923|CE:VMAT-TET|VMAT2 Inhibitors|09/25/2018| 47335027723|CE:VMAT-TET|VMAT2 Inhibitors|09/25/2018| 47335030888|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 47335034383|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 47335034383|CE:DRO-CERTIR5|Drug Regimen Optimization|01/31/2011| 47335034483|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 47335053183|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 47335053183|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 47335053188|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 47335053188|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 47335053383|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 47335053383|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 47335053388|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 47335053388|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 47335053783|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 47335053783|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 47335053788|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 47335053788|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 47335053981|CE:DRO-NIASA500|Drug Regimen Optimization|01/31/2011| 47335060313|CE:ALP-ALP|Alprazolam|05/28/2015| 47335060313|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47335060313|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47335060313|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47335060318|CE:ALP-ALP|Alprazolam|05/28/2015| 47335060318|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47335060318|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47335060318|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47335060388|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47335060388|CE:ALP-ALP|Alprazolam|05/28/2015| 47335060388|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47335060388|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47335060413|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47335060413|CE:ALP-ALP|Alprazolam|05/28/2015| 47335060413|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47335060413|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47335060418|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47335060418|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47335060418|CE:ALP-ALP|Alprazolam|05/28/2015| 47335060418|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47335060513|CE:ALP-ALP|Alprazolam|05/28/2015| 47335060513|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47335060513|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47335060513|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47335060588|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47335060588|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47335060588|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47335060588|CE:ALP-ALP|Alprazolam|05/28/2015| 47335060688|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47335060688|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47335060688|CE:ALP-ALP|Alprazolam|05/28/2015| 47335060688|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47335074349|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 47335074649|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 47335075349|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 47335085983|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 47335085983|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47335085983|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47335085983|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 47335086083|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47335086083|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 47335086083|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47335086083|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 47335086183|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47335086183|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47335090218|CE:APY-SGA|Antipsychotics|04/10/2016| 47335090288|CE:APY-SGA|Antipsychotics|04/10/2016| 47335090318|CE:APY-SGA|Antipsychotics|04/10/2016| 47335090388|CE:APY-SGA|Antipsychotics|04/10/2016| 47335090418|CE:APY-SGA|Antipsychotics|04/10/2016| 47335090488|CE:APY-SGA|Antipsychotics|04/10/2016| 47335090518|CE:APY-SGA|Antipsychotics|04/10/2016| 47335090588|CE:APY-SGA|Antipsychotics|04/10/2016| 47335090618|CE:APY-SGA|Antipsychotics|04/10/2016| 47335090688|CE:APY-SGA|Antipsychotics|04/10/2016| 47335090718|CE:APY-SGA|Antipsychotics|04/10/2016| 47335090788|CE:APY-SGA|Antipsychotics|04/10/2016| 47781010444|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 47781015301|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 47781015475|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 47781019601|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781019601|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781019601|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 47781019601|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 47781019605|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781019605|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 47781019605|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781019605|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 47781020404|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 47781020504|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 47781020604|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 47781020704|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 47781020804|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 47781020904|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 47781022901|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 47781022901|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 47781022901|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781022901|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781022905|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 47781022905|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781022905|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781022905|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 47781023001|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 47781023001|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781023001|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 47781023001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781023005|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 47781023005|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 47781023005|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781023005|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781023063|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 47781023063|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781023063|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 47781023063|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781026301|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 47781026301|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781026301|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 47781026301|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781026305|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781026305|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 47781026305|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 47781026305|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781026401|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781026401|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781026401|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 47781026401|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 47781026405|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781026405|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781026405|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 47781026405|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 47781026501|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781026501|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 47781026501|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781026501|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 47781026505|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 47781026505|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781026505|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781026505|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 47781035503|CE:SUB-SUBOX|Suboxone|04/23/2013| 47781035503|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781035503|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781035511|CE:SUB-SUBOX|Suboxone|04/23/2013| 47781035511|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781035511|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781035603|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781035603|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781035603|CE:SUB-SUBOX|Suboxone|04/23/2013| 47781035611|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781035611|CE:SUB-SUBOX|Suboxone|04/23/2013| 47781035611|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781035703|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781035703|CE:SUB-SUBOX|Suboxone|04/23/2013| 47781035703|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781035711|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781035711|CE:SUB-SUBOX|Suboxone|04/23/2013| 47781035711|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781035803|CE:SUB-SUBOX|Suboxone|04/23/2013| 47781035803|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781035803|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781035811|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781035811|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781035811|CE:SUB-SUBOX|Suboxone|04/23/2013| 47781036801|CE:DRO-NFP30|Drug Regimen Optimization|01/31/2011|03/31/2021 47781041501|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 47781041501|CE:DRO-MPHER18|Drug Regimen Optimization|01/31/2011| 47781041601|CE:DRO-MPHER27|Drug Regimen Optimization|01/31/2011| 47781041601|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 47781041701|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 47781041801|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 47781042347|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781042347|CE:DUR-DURAG|Duragesic (Fentanyl Transdermal)|01/31/2011| 47781042347|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781042347|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 47781042347|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 47781042447|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781042447|CE:DUR-DURAG|Duragesic (Fentanyl Transdermal)|01/31/2011| 47781042447|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 47781042447|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 47781042447|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781042647|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781042647|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 47781042647|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781042647|CE:DUR-DURAG|Duragesic (Fentanyl Transdermal)|01/31/2011| 47781042647|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 47781042747|CE:DUR-DURAG|Duragesic (Fentanyl Transdermal)|01/31/2011| 47781042747|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 47781042747|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 47781042747|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781042747|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781042847|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 47781042847|CE:DUR-DURAG|Duragesic (Fentanyl Transdermal)|01/31/2011| 47781042847|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781042847|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 47781042847|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 47781058568|CE:KET-KETINJ|Ketorolac|05/25/2012| 47781058568|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 49230064331|CE:FOS-FOSRENOL|Fosrenol (Lanthanum Carbonate)|01/31/2011| 49230064551|CE:FOS-FOSRENOL|Fosrenol (Lanthanum Carbonate)|01/31/2011| 49348001737|CE:DXO-DEXQ|Dextromethorphan Overutilization|07/16/2012| 49348001737|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 49348002827|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 49348004534|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 49348019609|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 49348054301|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 49348063634|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 49348070609|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 49348070610|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 49348086134|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 49348086134|CE:DXO-DEXQ|Dextromethorphan Overutilization|07/16/2012| 49502060561|CE:DUP-LABA|Duplicate Therapy|02/04/2016| 49884001908|CE:LVZ-LOVAZ|Lovaza|07/16/2012|03/31/2021 49884004801|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 49884004801|CE:DRO-DMX5|Drug Regimen Optimization|01/31/2011| 49884004901|CE:DRO-DMX10|Drug Regimen Optimization|01/31/2011| 49884004901|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 49884011074|CE:ALP-ALP|Alprazolam|05/28/2015| 49884011074|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 49884011074|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 49884011074|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 49884011174|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 49884011174|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 49884011174|CE:ALP-ALP|Alprazolam|05/28/2015| 49884011174|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 49884017211|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013|09/16/2021 49884017211|CE:DUP-ARB|Duplicate Therapy|02/05/2013|09/16/2021 49884017311|CE:DUP-ARB|Duplicate Therapy|02/05/2013|09/16/2021 49884017311|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013|09/16/2021 49884017411|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013|09/16/2021 49884017411|CE:DUP-ARB|Duplicate Therapy|02/05/2013|09/16/2021 49884017511|CE:DUP-ARB|Duplicate Therapy|02/05/2013|09/16/2021 49884017511|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013|09/16/2021 49884018511|CE:DUP-ARB|Duplicate Therapy|02/05/2013|09/16/2021 49884018511|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013|09/16/2021 49884018601|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 49884021255|CE:APY-ARI|Antipsychotics|04/10/2016| 49884021374|CE:ALP-ALP|Alprazolam|05/28/2015| 49884021374|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 49884021374|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 49884021374|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 49884021474|CE:ALP-ALP|Alprazolam|05/28/2015| 49884021474|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 49884021474|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 49884021474|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 49884024801|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 49884025011|CE:APY-SGA|Antipsychotics|04/10/2016| 49884025111|CE:APY-SGA|Antipsychotics|04/10/2016| 49884025211|CE:APY-SGA|Antipsychotics|04/10/2016| 49884025311|CE:APY-SGA|Antipsychotics|04/10/2016| 49884027711|CE:APY-SGA|Antipsychotics|04/10/2016| 49884030602|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 49884030602|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 49884030602|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 49884030602|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 49884030702|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 49884030702|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 49884030702|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 49884030702|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 49884030802|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 49884030802|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 49884030802|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 49884030802|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 49884030902|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 49884030902|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 49884030902|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 49884030902|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 49884031002|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 49884031002|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 49884031002|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 49884031002|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 49884031155|CE:APY-ARI|Antipsychotics|04/10/2016| 49884031155|CE:DRO-RISODT.5|Drug Regimen Optimization|01/31/2011| 49884031191|CE:APY-ARI|Antipsychotics|04/10/2016| 49884031191|CE:DRO-RISODT.5|Drug Regimen Optimization|01/31/2011| 49884031555|CE:DRO-RISODT1|Drug Regimen Optimization|01/31/2011| 49884031555|CE:APY-ARI|Antipsychotics|04/10/2016| 49884031591|CE:DRO-RISODT1|Drug Regimen Optimization|01/31/2011| 49884031591|CE:APY-ARI|Antipsychotics|04/10/2016| 49884032055|CE:DRO-OLAODT5|Drug Regimen Optimization|01/31/2011| 49884032055|CE:APY-SGA|Antipsychotics|04/10/2016| 49884032155|CE:DRO-OLAODT10|Drug Regimen Optimization|01/31/2011| 49884032155|CE:APY-SGA|Antipsychotics|04/10/2016| 49884032255|CE:APY-SGA|Antipsychotics|04/10/2016| 49884032355|CE:APY-SGA|Antipsychotics|04/10/2016| 49884033301|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 49884033901|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 49884034701|CE:APY-FGA|Antipsychotics|04/10/2016| 49884034801|CE:APY-FGA|Antipsychotics|04/10/2016| 49884040191|CE:APY-ARI|Antipsychotics|04/10/2016| 49884040191|CE:DRO-RISODT2|Drug Regimen Optimization|01/31/2011| 49884040291|CE:APY-ARI|Antipsychotics|04/10/2016| 49884040391|CE:APY-ARI|Antipsychotics|04/10/2016| 49884042411|CE:ASN-ALISK150|Aliskiren-Containing Agents|07/16/2012| 49884042511|CE:ASN-ALISK300|Aliskiren-Containing Agents|07/16/2012| 49884042801|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 49884043001|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 49884054601|CE:ADD-ERFocali|ADD/ADHD Agents|02/13/2014| 49884054902|CE:LTMC-ZAF|Leukotriene Modifiers - Clinical|12/15/2015| 49884055402|CE:LTMC-ZAF|Leukotriene Modifiers - Clinical|12/15/2015| 49884057411|CE:DUP-ARB|Duplicate Therapy|02/05/2013|01/06/2021 49884057511|CE:DUP-ARB|Duplicate Therapy|02/05/2013|01/06/2021 49884057611|CE:DUP-ARB|Duplicate Therapy|02/05/2013|01/06/2021 49884057711|CE:DUP-ARB|Duplicate Therapy|02/05/2013|01/06/2021 49884065809|CE:DRO-CARD4|Drug Regimen Optimization|01/31/2011| 49884065809|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 49884065909|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 49884065909|CE:DRO-CARD8|Drug Regimen Optimization|01/31/2011| 49884066009|CE:DRO-CARD16|Drug Regimen Optimization|01/31/2011| 49884066009|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 49884066109|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 49884072308|CE:LTMC-ZIL|Leukotriene Modifiers - Clinical|12/15/2015| 49884078709|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 49884078709|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 49884078711|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 49884078711|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 49884078809|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 49884078809|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 49884078811|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 49884078811|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 49884079009|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 49884079009|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 49884079011|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 49884079011|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 49884081911|CE:GIM-ALO|GI Motility|01/18/2017| 49884082011|CE:GIM-ALO|GI Motility|01/18/2017| 49884083901|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 49884083901|CE:DRO-APHXL5|Drug Regimen Optimization|01/31/2011| 49884084001|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 49884084001|CE:DRO-APHXL10|Drug Regimen Optimization|01/31/2011| 49884084101|CE:DRO-APHXK15|Drug Regimen Optimization|01/31/2011| 49884084101|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 49884084201|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 49884084301|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 49884084401|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 49884089811|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 49884089911|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 49884093547|CE:DUP-NSD|Duplicate Therapy|02/05/2013|03/05/2021 49884098401|CE:DUP-MGL|Duplicate Therapy|02/05/2013| 49884098501|CE:DUP-MGL|Duplicate Therapy|02/05/2013| 50111045901|CE:DUP-MLX|Duplicate Therapy|02/05/2013|11/23/2020 50111045902|CE:DUP-MLX|Duplicate Therapy|02/05/2013|11/23/2020 50111045903|CE:DUP-MLX|Duplicate Therapy|02/05/2013|11/23/2020 50111048201|CE:DUP-MLX|Duplicate Therapy|02/05/2013|11/23/2020 50111048202|CE:DUP-MLX|Duplicate Therapy|02/05/2013|11/23/2020 50111048203|CE:DUP-MLX|Duplicate Therapy|02/05/2013|11/23/2020 50111048301|CE:DUP-MLX|Duplicate Therapy|02/05/2013|11/23/2020 50111048302|CE:DUP-MLX|Duplicate Therapy|02/05/2013|11/23/2020 50111051801|CE:DUP-MLX|Duplicate Therapy|02/05/2013|11/23/2020 50228010901|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50228010901|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50228010901|CE:CCA-LDCARIS|Carisoprodol Containing Agents|01/31/2011| 50228010905|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50228010905|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50228010905|CE:CCA-LDCARIS|Carisoprodol Containing Agents|01/31/2011| 50228010910|CE:CCA-LDCARIS|Carisoprodol Containing Agents|01/31/2011| 50228010910|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50228010910|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50228013630|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 50228013690|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 50228014405|CE:DRO-BUPR150|Drug Regimen Optimization|01/31/2011| 50228014430|CE:DRO-BUPR150|Drug Regimen Optimization|01/31/2011| 50228014601|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 50228014605|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 50228014610|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 50228017701|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 50228017705|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 50228017801|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 50228017805|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 50228017901|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 50228017905|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 50228018001|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 50228018005|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 50228018101|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 50228018105|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 50228033910|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 50228033930|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 50228033990|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 50228034010|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 50228034010|CE:DRO-OLMES20|Drug Regimen Optimization|01/31/2011| 50228034030|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 50228034030|CE:DRO-OLMES20|Drug Regimen Optimization|01/31/2011| 50228034090|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 50228034090|CE:DRO-OLMES20|Drug Regimen Optimization|01/31/2011| 50228034110|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 50228034130|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 50228038060|CE:APY-SGA|Antipsychotics|04/10/2016| 50228038160|CE:APY-SGA|Antipsychotics|04/10/2016| 50228038260|CE:APY-SGA|Antipsychotics|04/10/2016| 50228038360|CE:APY-SGA|Antipsychotics|04/10/2016| 50228038460|CE:APY-SGA|Antipsychotics|04/10/2016| 50228042360|CE:RAN-RAN|Ranolazine|05/25/2012| 50228042460|CE:RAN-RAN|Ranolazine|05/25/2012| 50228042730|CE:DRO-SOLAF5|Drug Regimen Optimization|01/31/2011| 50228042790|CE:DRO-SOLAF5|Drug Regimen Optimization|01/31/2011| 50228043201|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 50228043205|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 50228043301|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 50228043305|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 50228043401|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 50228043405|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 50228043501|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 50228043505|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 50228043601|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 50228043605|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 50228046501|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 50228046505|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 50228046601|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 50228046605|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 50242007401|CE:GRH-NPGROWTH|Growth Hormones|01/31/2011| 50242007501|CE:GRH-NPGROWTH|Growth Hormones|01/31/2011| 50242007601|CE:GRH-NPGROWTH|Growth Hormones|01/31/2011| 50242013801|CE:CYC-ACTE|Cytokine and CAM Antagonists|03/27/2018| 50242014301|CE:CYC-ACTE|Cytokine and CAM Antagonists|03/27/2018| 50268014411|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50268014411|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50268014411|CE:SUB-SUBOX|Suboxone|04/23/2013| 50268014415|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50268014415|CE:SUB-SUBOX|Suboxone|04/23/2013| 50268014415|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50268014511|CE:SUB-SUBOX|Suboxone|04/23/2013| 50268014511|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50268014511|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50268014515|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50268014515|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50268014515|CE:SUB-SUBOX|Suboxone|04/23/2013| 50383004004|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 50383004004|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 50383004224|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 50383004224|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 50383004248|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 50383004248|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 50383004316|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 50383004316|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50383004316|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 50383004316|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50383007916|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50383007916|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 50383007916|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50383008716|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50383008716|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50383008716|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 50383008716|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 50383027201|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 50383028793|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50383028793|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50383028793|CE:SUB-SUBOX|Suboxone|04/23/2013| 50383029493|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50383029493|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50383029493|CE:SUB-SUBOX|Suboxone|04/23/2013| 50383031147|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 50383070530|CE:ASH-LORAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 50383070530|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50383070530|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50383070530|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50383074120|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 50383080116|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 50383080116|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 50383080416|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 50383080416|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50383080416|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 50383080416|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 50383080416|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50383080416|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 50383092493|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50383092493|CE:STX-STX|Subutex (buprenorphine)|12/05/2014| 50383092493|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50383093093|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50383093093|CE:STX-STX|Subutex (buprenorphine)|12/05/2014| 50383093093|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50383096134|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 50383096134|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 50383096134|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50383096134|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50383096430|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50383096430|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 50383096430|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50383096504|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50383096504|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 50383096504|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 50383096504|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50383096530|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 50383096530|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50383096530|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 50383096530|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50419045104|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 50419045204|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 50419045304|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 50419045404|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 50419045504|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 50419045604|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 50419045904|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 50419048303|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 50419049104|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 50458010205|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50458010205|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 50458010205|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50458010205|CE:DUR-DURAG|Duragesic (Fentanyl Transdermal)|01/31/2011| 50458010205|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 50458030001|CE:DRO-RISP1|Drug Regimen Optimization|01/31/2011| 50458030001|CE:APY-ARI|Antipsychotics|04/10/2016| 50458030006|CE:DRO-RISP1|Drug Regimen Optimization|01/31/2011| 50458030006|CE:APY-ARI|Antipsychotics|04/10/2016| 50458030206|CE:DRO-RISP0.5|Drug Regimen Optimization|01/31/2011| 50458030206|CE:APY-ARI|Antipsychotics|04/10/2016| 50458030503|CE:APY-ARI|Antipsychotics|04/10/2016| 50458030611|CE:APY-SGA|Antipsychotics|04/10/2016| 50458030611|CE:DRO-RISPM25|Drug Regimen Optimization|01/31/2011| 50458030611|CE:APY-ARI|Antipsychotics|04/10/2016| 50458030711|CE:APY-SGA|Antipsychotics|04/10/2016| 50458030711|CE:APY-ARI|Antipsychotics|04/10/2016| 50458030811|CE:APY-SGA|Antipsychotics|04/10/2016| 50458030811|CE:APY-ARI|Antipsychotics|04/10/2016| 50458030911|CE:APY-SGA|Antipsychotics|04/10/2016| 50458030911|CE:APY-ARI|Antipsychotics|04/10/2016| 50458032001|CE:DRO-RISP2|Drug Regimen Optimization|01/31/2011| 50458032001|CE:APY-ARI|Antipsychotics|04/10/2016| 50458032006|CE:DRO-RISP2|Drug Regimen Optimization|01/31/2011| 50458032006|CE:APY-ARI|Antipsychotics|04/10/2016| 50458033001|CE:APY-ARI|Antipsychotics|04/10/2016| 50458033006|CE:APY-ARI|Antipsychotics|04/10/2016| 50458035001|CE:APY-ARI|Antipsychotics|04/10/2016| 50458035006|CE:APY-ARI|Antipsychotics|04/10/2016| 50458055001|CE:APY-SGA|Antipsychotics|04/10/2016| 50458055101|CE:APY-SGA|Antipsychotics|04/10/2016| 50458055110|CE:APY-SGA|Antipsychotics|04/10/2016|11/23/2020 50458055201|CE:APY-SGA|Antipsychotics|04/10/2016| 50458055210|CE:APY-SGA|Antipsychotics|04/10/2016|11/23/2020 50458055401|CE:APY-SGA|Antipsychotics|04/10/2016| 50458056001|CE:APY-SGA|Antipsychotics|04/10/2016| 50458056101|CE:APY-SGA|Antipsychotics|04/10/2016| 50458056201|CE:APY-SGA|Antipsychotics|04/10/2016| 50458056301|CE:APY-SGA|Antipsychotics|04/10/2016| 50458056401|CE:APY-SGA|Antipsychotics|04/10/2016| 50458057710|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 50458057718|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 50458057760|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 50458057810|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 50458057830|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 50458057890|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 50458057910|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 50458057930|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 50458057989|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 50458057990|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 50458058010|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 50458058030|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 50458058451|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 50458058501|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 50458058501|CE:DRO-MPHER18|Drug Regimen Optimization|01/31/2011| 50458058601|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 50458058701|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 50458058801|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 50458058801|CE:DRO-MPHER27|Drug Regimen Optimization|01/31/2011| 50458059601|CE:APY-ARI|Antipsychotics|04/10/2016| 50458060601|CE:APY-SGA|Antipsychotics|04/10/2016| 50458060701|CE:APY-SGA|Antipsychotics|04/10/2016| 50458060801|CE:APY-SGA|Antipsychotics|04/10/2016| 50458060901|CE:APY-SGA|Antipsychotics|04/10/2016| 50458065060|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50458065060|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50458065060|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 50458065060|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 50458065960|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 50458065960|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50458065960|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 50458065960|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50458080501|CE:DRO-OXYBU5|Drug Regimen Optimization|01/31/2011| 50474071079|CE:CYC-CIMZ|Cytokine and CAM Antagonists|03/27/2018| 50474071081|CE:CYC-CIMZ|Cytokine and CAM Antagonists|03/27/2018| 50742018921|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 50742018921|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 50742019001|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 50742019010|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 50742024760|CE:ADD-KAPVAY|ADD/ADHD Agents|02/13/2014| 50742025601|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50742025601|CE:CCA-CARISCPD|Carisoprodol Containing Agents|01/31/2011| 50742025601|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 50742025601|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50742025601|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 50742026001|CE:DRO-NFP30|Drug Regimen Optimization|01/31/2011| 50742026003|CE:DRO-NFP30|Drug Regimen Optimization|01/31/2011| 50742030805|CE:DUP-NSD|Duplicate Therapy|02/05/2013|01/31/2021 50742062001|CE:DRO-NFP30|Drug Regimen Optimization|01/31/2011| 50742063560|CE:APY-SGA|Antipsychotics|04/10/2016| 50742063660|CE:APY-SGA|Antipsychotics|04/10/2016| 50742063760|CE:APY-SGA|Antipsychotics|04/10/2016| 50742063860|CE:APY-SGA|Antipsychotics|04/10/2016| 50742063960|CE:APY-SGA|Antipsychotics|04/10/2016| 50742065601|CE:CCA-LDCARIS|Carisoprodol Containing Agents|01/31/2011| 50742065601|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50742065601|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 50742065728|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 50742065784|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 50742065828|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 50742065884|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 50991021201|CE:CCC-CCCA|Cough and Cold Agents - Clinical|12/15/2015| 50991021401|CE:DXO-DEXY|Dextromethorphan Overutilization|07/16/2012| 50991021401|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 50991021601|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013|12/31/2021 50991021601|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015|12/31/2021 50991022016|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 50991022016|CE:DXO-DEXO|Dextromethorphan Overutilization|07/16/2012| 50991022016|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 50991022245|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015|03/31/2022 50991022245|CE:CCC-CCCA|Cough and Cold Agents - Clinical|12/15/2015|03/31/2022 50991062601|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 50991062601|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 50991073690|CE:CCC-CCCA|Cough and Cold Agents - Clinical|12/15/2015| 50991073890|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015|02/28/2021 50991073890|CE:DXO-DEXAA|Dextromethorphan Overutilization|07/16/2012|02/28/2021 50991074001|CE:DXO-DEXAA|Dextromethorphan Overutilization|07/16/2012| 50991074001|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 50991078290|CE:CCC-CCCA|Cough and Cold Agents - Clinical|12/15/2015|10/01/2021 50991078290|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013|10/01/2021 50991078360|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 50991078490|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 50991082616|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 50991082616|CE:DXO-DEXN|Dextromethorphan Overutilization|07/16/2012| 51079007820|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013|12/31/2020 51079008620|CE:DRO-MIRTZA15|Drug Regimen Optimization|01/31/2011| 51079013020|CE:APY-FGA|Antipsychotics|04/10/2016|11/23/2020 51079014120|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51079014120|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51079014120|CE:ASH-CMOXAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 51079014120|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51079016120|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|01/31/2021 51079016120|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|01/31/2021 51079016120|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020|01/31/2021 51079016120|CE:OPO-OOVU|Opiate Overutilization|11/05/2013|01/31/2021 51079019703|CE:DRO-TOLTLA2|Drug Regimen Optimization|01/31/2011| 51079020820|CE:DRO-ATORV10|Drug Regimen Optimization|01/31/2011| 51079020820|CE:DUP-STN|Duplicate Therapy|02/04/2016| 51079020920|CE:DUP-STN|Duplicate Therapy|02/04/2016| 51079020920|CE:DRO-ATORV20|Drug Regimen Optimization|01/31/2011| 51079021020|CE:DRO-ATORV40|Drug Regimen Optimization|01/31/2011| 51079021020|CE:DUP-STN|Duplicate Therapy|02/04/2016| 51079021103|CE:DUP-STN|Duplicate Therapy|02/04/2016| 51079028804|CE:APY-SGA|Antipsychotics|04/10/2016| 51079037420|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51079037420|CE:ASH-CMOXAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 51079037420|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51079037420|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51079037520|CE:ASH-CMOXAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 51079037520|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51079037520|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51079037520|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51079043120|CE:APY-FGA|Antipsychotics|04/10/2016| 51079045820|CE:DRO-PRAVA20|Drug Regimen Optimization|01/31/2011| 51079045820|CE:DUP-STN|Duplicate Therapy|02/04/2016| 51079048720|CE:APY-FGA|Antipsychotics|04/10/2016|10/31/2020 51079048820|CE:APY-FGA|Antipsychotics|04/10/2016|12/31/2020 51079051720|CE:APY-FGA|Antipsychotics|04/10/2016|04/30/2021 51079051820|CE:APY-FGA|Antipsychotics|04/10/2016|11/30/2020 51079051920|CE:APY-FGA|Antipsychotics|04/10/2016|01/31/2021 51079057220|CE:APY-FGA|Antipsychotics|04/10/2016| 51079057320|CE:APY-FGA|Antipsychotics|04/10/2016| 51079057420|CE:APY-FGA|Antipsychotics|04/10/2016| 51079057520|CE:APY-FGA|Antipsychotics|04/10/2016| 51079059720|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 51079073320|CE:APY-FGA|Antipsychotics|04/10/2016| 51079073420|CE:APY-FGA|Antipsychotics|04/10/2016| 51079073520|CE:APY-FGA|Antipsychotics|04/10/2016| 51079073620|CE:APY-FGA|Antipsychotics|04/10/2016| 51079074920|CE:APY-SGA|Antipsychotics|04/10/2016| 51079076608|CE:DRO-DIVAL250|Drug Regimen Optimization|01/31/2011| 51079077420|CE:DRO-PRX20|Drug Regimen Optimization|01/31/2011|10/31/2020 51079077620|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013|06/30/2021 51079078220|CE:DRO-PRAVA40|Drug Regimen Optimization|01/31/2011| 51079078220|CE:DUP-STN|Duplicate Therapy|02/04/2016| 51079092120|CE:APY-SGA|Antipsychotics|04/10/2016| 51079092220|CE:APY-SGA|Antipsychotics|04/10/2016| 51079093520|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013|01/31/2021 51079093620|CE:DRO-TERAZO1|Drug Regimen Optimization|01/31/2011|01/31/2021 51079093820|CE:DRO-TERAZO5|Drug Regimen Optimization|01/31/2011|02/28/2021 51079095720|CE:DRO-DOXA1|Drug Regimen Optimization|01/31/2011|10/31/2020 51079095820|CE:DRO-DOXA2|Drug Regimen Optimization|01/31/2011|04/30/2021 51079095920|CE:DRO-DOXA4|Drug Regimen Optimization|01/31/2011|04/30/2021 51079099120|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51079099120|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 51079099120|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 51079099120|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51167011301|CE:SYM-SYM|Symdeko|07/17/2018| 51167020001|CE:KAL-KALY|Kalydeco|04/29/2013| 51167030001|CE:KAL-KALY|Kalydeco|04/29/2013| 51167033101|CE:TRK-TRK|Trikafta|02/24/2020| 51167040001|CE:KAL-KALY|Kalydeco|04/29/2013| 51167050002|CE:ORK1-ORK1|Orkambi 100/125|12/04/2016| 51167060001|CE:KAL-KALY|Kalydeco|04/29/2013| 51167066101|CE:SYM-SYM|Symdeko|07/17/2018| 51167070002|CE:ORK1-ORK1|Orkambi 100/125|12/04/2016| 51167080901|CE:ORK-ORK|Orkambi|01/05/2016| 51167090001|CE:ORK1-ORK1|Orkambi 100/125|12/04/2016| 51224000150|CE:CCC-CCCC|Cough and Cold Agents - Clinical|12/15/2015| 51224000160|CE:CCC-CCCC|Cough and Cold Agents - Clinical|12/15/2015| 51224001050|CE:CCC-CCCC|Cough and Cold Agents - Clinical|12/15/2015| 51224001060|CE:CCC-CCCC|Cough and Cold Agents - Clinical|12/15/2015| 51224001960|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 51224002150|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 51224002160|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 51224011960|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 51224012150|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 51224012160|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 51224042510|CE:VMAT-TET|VMAT2 Inhibitors|09/25/2018| 51224042610|CE:VMAT-TET|VMAT2 Inhibitors|09/25/2018| 51248015001|CE:DRO-SOLAF5|Drug Regimen Optimization|01/31/2011| 51248015003|CE:DRO-SOLAF5|Drug Regimen Optimization|01/31/2011| 51285004001|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 51285004702|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 51285005002|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 51285006390|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 51525023403|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 51525029403|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 51525590101|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51525590101|CE:CCA-LDCARIS|Carisoprodol Containing Agents|01/31/2011| 51525590101|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51672136307|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 51672138508|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 51672138509|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 51672207308|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 51672209208|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 51672210208|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 51672213008|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 51672213108|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 51672401601|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 51672401701|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 51672401801|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 51672402701|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 51672402703|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 51672402801|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 51672402803|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 51672402901|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 51672402903|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 51672403001|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 51672403003|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 51672403101|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 51672403103|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 51672403201|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 51672403203|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 51672403301|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 51672403303|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 51672403401|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 51672403403|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 51672403501|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 51672403503|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 51672403601|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 51672404201|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51672404201|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51672404201|CE:ASH-CLORAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 51672404201|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51672404202|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51672404202|CE:ASH-CLORAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 51672404202|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51672404202|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51672404301|CE:ASH-CLORAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 51672404301|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51672404301|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51672404301|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51672404302|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51672404302|CE:ASH-CLORAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 51672404302|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51672404302|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51672404401|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51672404401|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51672404401|CE:ASH-CLORAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 51672404401|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51672404501|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 51672404601|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 51672405101|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 51672405104|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 51672405201|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 51672405204|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 51672405301|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 51672405304|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 51672407008|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 51672416108|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 51672529601|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 51672529701|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 51862006060|CE:ADD-KAPVAY|ADD/ADHD Agents|02/13/2014| 51862006201|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51862006201|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 51862006201|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51862006201|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51862006205|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|11/30/2020 51862006205|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|11/30/2020 51862006205|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011|11/30/2020 51862006205|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|11/30/2020 51862006301|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 51862006301|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51862006301|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51862006301|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51862006305|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|07/31/2021 51862006305|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|07/31/2021 51862006305|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011|07/31/2021 51862006305|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|07/31/2021 51862006310|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 51862006310|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51862006310|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51862006310|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51862006401|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|11/30/2020 51862006401|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|11/30/2020 51862006401|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011|11/30/2020 51862006401|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|11/30/2020 51862006405|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|02/28/2021 51862006405|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|02/28/2021 51862006405|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011|02/28/2021 51862006405|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|02/28/2021 51862006410|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51862006410|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51862006410|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 51862006410|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51862006901|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51862006901|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 51862006901|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51862006901|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51862007001|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51862007001|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51862007001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51862007001|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 51862018501|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51862018501|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51862018501|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 51862018501|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 51862018601|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51862018601|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 51862018601|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51862018601|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 51862018701|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 51862018701|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51862018701|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 51862018701|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51862018801|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 51862018801|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51862018801|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 51862018801|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51862027101|CE:APY-SGA|Antipsychotics|04/10/2016| 51862027105|CE:APY-SGA|Antipsychotics|04/10/2016| 51862027201|CE:APY-SGA|Antipsychotics|04/10/2016| 51862027205|CE:APY-SGA|Antipsychotics|04/10/2016| 51862027301|CE:APY-SGA|Antipsychotics|04/10/2016| 51862027305|CE:APY-SGA|Antipsychotics|04/10/2016| 51862027401|CE:APY-SGA|Antipsychotics|04/10/2016| 51862027405|CE:APY-SGA|Antipsychotics|04/10/2016| 51862031778|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|06/30/2021 51862031778|CE:DUR-DURAG|Duragesic (Fentanyl Transdermal)|01/31/2011|06/30/2021 51862031778|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020|06/30/2021 51862031778|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|06/30/2021 51862031778|CE:OPO-OOVU|Opiate Overutilization|11/05/2013|06/30/2021 51862033201|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 51862033301|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 51862033305|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 51862033401|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 51862033405|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 51862034490|CE:ADD-ERDEX|ADD/ADHD Agents|02/13/2014| 51862034590|CE:ADD-ERDEX|ADD/ADHD Agents|02/13/2014| 51862034690|CE:ADD-ERDEX|ADD/ADHD Agents|02/13/2014| 51862053504|CE:DXO-DEXQ|Dextromethorphan Overutilization|07/16/2012| 51862053504|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 51862053504|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 51862053516|CE:DXO-DEXQ|Dextromethorphan Overutilization|07/16/2012| 51862053516|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 51862053516|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 51862058001|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 51862058001|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 51862058201|CE:DUP-OCS|Duplicate Therapy|02/04/2016|06/30/2021 51862058201|CE:DUP-OCRT|Duplicate Therapy|02/05/2013|06/30/2021 51862058501|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|09/30/2021 51862058501|CE:OPO-OOVU|Opiate Overutilization|11/05/2013|09/30/2021 51862058501|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|09/30/2021 51862058501|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020|09/30/2021 51862058505|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020|11/23/2020 51862058505|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|11/23/2020 51862058505|CE:OPO-OOVU|Opiate Overutilization|11/05/2013|11/23/2020 51862058505|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|11/23/2020 51862058601|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|06/30/2021 51862058601|CE:OPO-OOVU|Opiate Overutilization|11/05/2013|06/30/2021 51862058601|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|06/30/2021 51862058601|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020|06/30/2021 51862058605|CE:OPO-OOVU|Opiate Overutilization|11/05/2013|06/30/2021 51862058605|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|06/30/2021 51862058605|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020|06/30/2021 51862058605|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|06/30/2021 51862058701|CE:OPO-OOVU|Opiate Overutilization|11/05/2013|10/31/2021 51862058701|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020|10/31/2021 51862058701|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|10/31/2021 51862058701|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|10/31/2021 51862058705|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 51862058705|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 51862058705|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51862058705|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51862060901|CE:DRO-MPHER10|Drug Regimen Optimization|01/31/2011| 51862060901|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 51862061001|CE:DRO-MPHER20|Drug Regimen Optimization|01/31/2011| 51862061001|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 51862061101|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 51862061201|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 51862061430|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 51862063428|CE:FEN-FENT100|Fentora|09/24/2017| 51862063428|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51862063428|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51862063428|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 51862063428|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 51862063528|CE:FEN-FENT200|Fentora|09/24/2017| 51862063528|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 51862063528|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 51862063528|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51862063528|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51862063628|CE:FEN-FENT400|Fentora|09/24/2017| 51862063628|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 51862063628|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51862063628|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51862063628|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 51862063728|CE:FEN-FENT6&8|Fentora|09/24/2017| 51862063728|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51862063728|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 51862063728|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51862063728|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 51862063828|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51862063828|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 51862063828|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 51862063828|CE:FEN-FENT6&8|Fentora|09/24/2017| 51862063828|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51862094205|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 51862094205|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51862094205|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51862094205|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51862094301|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 51862094301|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51862094301|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51862094301|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51862094305|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 51862094305|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51862094305|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51862094305|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51991007301|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 51991007301|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51991007301|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 51991007301|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51991007401|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51991007401|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51991007401|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 51991007401|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 51991007405|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51991007405|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 51991007405|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 51991007405|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51991033301|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 51991033404|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 51991047428|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 51991061150|CE:ADD-IRMETHYL|ADD/ADHD Agents|02/13/2014| 51991061250|CE:ADD-IRMETHYL|ADD/ADHD Agents|02/13/2014| 51991062328|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 51991064310|CE:DRO-OMP20|Drug Regimen Optimization|01/31/2011| 51991070401|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51991070401|CE:ALP-ALP|Alprazolam|05/28/2015| 51991070401|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51991070401|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51991070405|CE:ALP-ALP|Alprazolam|05/28/2015| 51991070405|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51991070405|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51991070405|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51991070410|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51991070410|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51991070410|CE:ALP-ALP|Alprazolam|05/28/2015| 51991070410|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51991070501|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51991070501|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51991070501|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51991070501|CE:ALP-ALP|Alprazolam|05/28/2015| 51991070505|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51991070505|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51991070505|CE:ALP-ALP|Alprazolam|05/28/2015| 51991070505|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51991070510|CE:ALP-ALP|Alprazolam|05/28/2015| 51991070510|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51991070510|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51991070510|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51991070601|CE:ALP-ALP|Alprazolam|05/28/2015| 51991070601|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51991070601|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51991070601|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51991070605|CE:ALP-ALP|Alprazolam|05/28/2015| 51991070605|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51991070605|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51991070605|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51991070610|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51991070610|CE:ALP-ALP|Alprazolam|05/28/2015| 51991070610|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51991070610|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51991070701|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51991070701|CE:ALP-ALP|Alprazolam|05/28/2015| 51991070701|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51991070701|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51991070705|CE:ALP-ALP|Alprazolam|05/28/2015| 51991070705|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51991070705|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51991070705|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 51991071641|CE:APY-ARI|Antipsychotics|04/10/2016|11/30/2020 51991073520|CE:AEM-ANTIEME|Antiemetics Oral|01/31/2011| 51991073532|CE:AEM-ANTIEME|Antiemetics Oral|01/31/2011| 51991077133|CE:DRO-LPZ15|Drug Regimen Optimization|01/31/2011|12/31/2020 51991081403|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 51991083704|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 51991083716|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 51991083801|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 51991083810|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 51991083933|CE:DUP-NSD|Duplicate Therapy|02/05/2013|11/23/2020 51991085301|CE:DUP-MGL|Duplicate Therapy|02/05/2013| 51991085401|CE:DUP-MGL|Duplicate Therapy|02/05/2013| 51991085501|CE:DUP-MGL|Duplicate Therapy|02/05/2013| 51991089333|CE:DRO-SOLAF5|Drug Regimen Optimization|01/31/2011|01/31/2021 51991089390|CE:DRO-SOLAF5|Drug Regimen Optimization|01/31/2011|01/31/2021 52054051209|CE:ADD-ERDEX|ADD/ADHD Agents|02/13/2014| 52054051309|CE:ADD-ERDEX|ADD/ADHD Agents|02/13/2014| 52054051409|CE:ADD-ERDEX|ADD/ADHD Agents|02/13/2014| 52244010010|CE:DUP-MLX|Duplicate Therapy|02/05/2013| 52244020010|CE:DUP-MLX|Duplicate Therapy|02/05/2013| 52244030010|CE:DUP-MLX|Duplicate Therapy|02/05/2013| 52244040010|CE:DUP-MLX|Duplicate Therapy|02/05/2013| 52244040410|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013|12/31/2020 52244044910|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 52244044910|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 52427038290|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 52427038390|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 52427043690|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 52427043790|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 52427049401|CE:DRO-NFP30|Drug Regimen Optimization|01/31/2011| 52427069203|CE:SUB-SUBOX|Suboxone|04/23/2013| 52427069203|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 52427069203|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 52427069211|CE:SUB-SUBOX|Suboxone|04/23/2013| 52427069211|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 52427069211|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 52427069403|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 52427069403|CE:SUB-SUBOX|Suboxone|04/23/2013| 52427069403|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 52427069411|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 52427069411|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 52427069411|CE:SUB-SUBOX|Suboxone|04/23/2013| 52427069803|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 52427069803|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 52427069803|CE:SUB-SUBOX|Suboxone|04/23/2013| 52427069811|CE:SUB-SUBOX|Suboxone|04/23/2013| 52427069811|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 52427069811|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 52427071203|CE:SUB-SUBOX|Suboxone|04/23/2013| 52427071203|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 52427071203|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 52427071211|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 52427071211|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 52427071211|CE:SUB-SUBOX|Suboxone|04/23/2013| 52536050001|CE:ADD-IRZen|ADD/ADHD Agents|02/13/2014| 52536051001|CE:ADD-IRZen|ADD/ADHD Agents|02/13/2014| 52544023912|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 52544047108|CE:DUP-HRT|Duplicate Therapy|02/05/2013|12/31/2020 52565000205|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 52817013110|CE:DRO-VENL37.5|Drug Regimen Optimization|01/31/2011|11/13/2020 52817016060|CE:APY-SGA|Antipsychotics|04/10/2016| 52817016160|CE:APY-SGA|Antipsychotics|04/10/2016| 52817016260|CE:APY-SGA|Antipsychotics|04/10/2016| 52817016360|CE:APY-SGA|Antipsychotics|04/10/2016| 52817016460|CE:APY-SGA|Antipsychotics|04/10/2016| 52817019100|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011|11/30/2020 52817019100|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|11/30/2020 52817019100|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|11/30/2020 52817021010|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 52817021050|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 52817029590|CE:SDF-REVATIO|Sildenafil (Revatio)|01/31/2011| 52817033010|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011| 52817033010|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 52817033010|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 52817033050|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011| 52817033050|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 52817033050|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 52817033110|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 52817033110|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 52817033110|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011| 52817033200|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 52817033200|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011| 52817033200|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 52817033250|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 52817033250|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011| 52817033250|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 52856050101|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 52856050101|CE:EMF-EMF|Emflaza|09/24/2017| 52856050101|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 52856050203|CE:EMF-EMF|Emflaza|09/24/2017| 52856050203|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 52856050203|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 52856050303|CE:EMF-EMF|Emflaza|09/24/2017| 52856050303|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 52856050303|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 52856050403|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 52856050403|CE:EMF-EMF|Emflaza|09/24/2017| 52856050403|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 52856050521|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 52856050521|CE:EMF-EMF|Emflaza|09/24/2017| 52856050521|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 52856050522|CE:EMF-EMF|Emflaza|09/24/2017| 52856050522|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 52856050522|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 53451010101|CE:GAB-HORI|Anticonvulsant Agents (Gabapentin)|02/06/2018| 53451010301|CE:GAB-HORI|Anticonvulsant Agents (Gabapentin)|02/06/2018| 53489014401|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 53489014405|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 53489014410|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 53489014801|CE:APY-FGA|Antipsychotics|04/10/2016| 53489014810|CE:APY-FGA|Antipsychotics|04/10/2016| 53489014901|CE:APY-FGA|Antipsychotics|04/10/2016| 53489014910|CE:APY-FGA|Antipsychotics|04/10/2016| 53489015001|CE:APY-FGA|Antipsychotics|04/10/2016| 53489015010|CE:APY-FGA|Antipsychotics|04/10/2016| 53489036801|CE:DRO-FLP2.5|Drug Regimen Optimization|01/31/2011| 53489036901|CE:DRO-FLP5|Drug Regimen Optimization|01/31/2011| 53489047801|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 53489047805|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 53489047901|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 53489047905|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 53489050001|CE:APY-FGA|Antipsychotics|04/10/2016| 53489050601|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 53489064801|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 53489064801|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 53489064801|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 53489064801|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 53489065007|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 53489065007|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 53489065007|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 53489065007|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 53746010101|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011|11/23/2020 53746010105|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011|12/17/2020 53746010110|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011|11/23/2020 53746010205|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011|12/17/2020 53746010210|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011|11/23/2020 53746010301|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011|11/23/2020 53746010901|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 53746010901|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 53746010901|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 53746010901|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 53746010905|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 53746010905|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 53746010905|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 53746010905|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 53746010910|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020|09/04/2021 53746010910|CE:OPO-OOVU|Opiate Overutilization|11/05/2013|09/04/2021 53746010910|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|09/04/2021 53746010910|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|09/04/2021 53746011001|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 53746011001|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 53746011001|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 53746011001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 53746011005|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 53746011005|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 53746011005|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 53746011005|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 53746011010|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 53746011010|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 53746011010|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 53746011010|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 53746011701|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 53746011701|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 53746011701|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 53746011701|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 53746011701|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 53746014501|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 53746014501|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 53746014501|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 53746014501|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 53746014501|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 53746014601|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 53746014601|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 53746014601|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 53746014601|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 53746014601|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 53746019010|CE:DUP-NSD|Duplicate Therapy|02/05/2013|09/30/2022 53746019301|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 53746019401|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 53746019405|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 53746020301|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 53746020301|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 53746020301|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 53746020301|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 53746020305|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 53746020305|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 53746020305|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 53746020305|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 53746020401|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 53746020401|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 53746020401|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 53746020401|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 53746020405|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 53746020405|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 53746020405|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 53746020405|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 53746061701|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 53746061701|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 53746061701|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 53746061701|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 53746061705|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 53746061705|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 53746061705|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 53746061705|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 53746061710|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 53746061710|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 53746061710|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 53746061710|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 54092025290|CE:FOS-FOSRENOL|Fosrenol (Lanthanum Carbonate)|01/31/2011| 54092025390|CE:FOS-FOSRENOL|Fosrenol (Lanthanum Carbonate)|01/31/2011| 54092025490|CE:FOS-FOSRENOL|Fosrenol (Lanthanum Carbonate)|01/31/2011| 54092025602|CE:FOS-FOSRENOL|Fosrenol (Lanthanum Carbonate)|01/31/2011| 54092025702|CE:FOS-FOSRENOL|Fosrenol (Lanthanum Carbonate)|01/31/2011| 54092038101|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 54092038101|CE:DRO-APHXL5|Drug Regimen Optimization|01/31/2011| 54092038301|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 54092038301|CE:DRO-APHXL10|Drug Regimen Optimization|01/31/2011| 54092038501|CE:DRO-APHXK15|Drug Regimen Optimization|01/31/2011| 54092038501|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 54092038701|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 54092038901|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 54092039101|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 54092046801|CE:ADD-ERMYD|ADD/ADHD Agents|09/24/2017| 54092047101|CE:ADD-ERMYD|ADD/ADHD Agents|09/24/2017| 54092047401|CE:ADD-ERMYD|ADD/ADHD Agents|09/24/2017| 54092047701|CE:ADD-ERMYD|ADD/ADHD Agents|09/24/2017| 54092051302|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 54092051502|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 54092051702|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 54092051902|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 54092070001|CE:ENZ-ELA|Enzymes|11/20/2019| 54123011430|CE:SUB-SUBOX|Suboxone|04/23/2013| 54123090730|CE:SUB-SUBOX|Suboxone|04/23/2013| 54123091430|CE:SUB-SUBOX|Suboxone|04/23/2013| 54123091430|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 54123091430|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 54123092930|CE:SUB-SUBOX|Suboxone|04/23/2013| 54123095730|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 54123095730|CE:SUB-SUBOX|Suboxone|04/23/2013| 54123095730|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 54123098630|CE:SUB-SUBOX|Suboxone|04/23/2013| 54569639900|CE:SUB-SUBOX|Suboxone|04/23/2013| 54569639900|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 54569639900|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 54766089403|CE:GIM-ALO|GI Motility|01/18/2017| 54766089503|CE:GIM-ALO|GI Motility|01/18/2017| 54838011540|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 54838011540|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 54838011540|CE:DXO-DEXQCHLD|Dextromethorphan Overutilization|07/16/2012| 54838011740|CE:CCC-CCCA|Cough and Cold Agents - Clinical|12/15/2015| 54838011770|CE:CCC-CCCA|Cough and Cold Agents - Clinical|12/15/2015| 54838011780|CE:CCC-CCCA|Cough and Cold Agents - Clinical|12/15/2015| 54838013340|CE:DXO-DEXQ|Dextromethorphan Overutilization|07/16/2012| 54838013340|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 54838013540|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 54838013570|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 54838013580|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 54838013640|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 54838013640|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 54838013640|CE:DXO-DEXQCHLD|Dextromethorphan Overutilization|07/16/2012| 54838013670|CE:DXO-DEXQCHLD|Dextromethorphan Overutilization|07/16/2012| 54838013670|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 54838013670|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 54838020940|CE:DXO-DEXQ|Dextromethorphan Overutilization|07/16/2012| 54838020940|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 54838020970|CE:DXO-DEXQ|Dextromethorphan Overutilization|07/16/2012| 54838020970|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 54838020980|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 54838020980|CE:DXO-DEXQ|Dextromethorphan Overutilization|07/16/2012| 54838050140|CE:APY-FGA|Antipsychotics|04/10/2016| 54838050280|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 54838055240|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 54838055680|CE:DUP-MLX|Duplicate Therapy|02/05/2013| 54838055840|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 54838057059|CE:APY-ARI|Antipsychotics|04/10/2016| 54838057280|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 54879000308|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 54879000308|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 55111012105|CE:DRO-ATORV10|Drug Regimen Optimization|01/31/2011| 55111012105|CE:DUP-STN|Duplicate Therapy|02/04/2016| 55111012190|CE:DRO-ATORV10|Drug Regimen Optimization|01/31/2011| 55111012190|CE:DUP-STN|Duplicate Therapy|02/04/2016| 55111012205|CE:DUP-STN|Duplicate Therapy|02/04/2016| 55111012205|CE:DRO-ATORV20|Drug Regimen Optimization|01/31/2011| 55111012290|CE:DRO-ATORV20|Drug Regimen Optimization|01/31/2011| 55111012290|CE:DUP-STN|Duplicate Therapy|02/04/2016| 55111012305|CE:DUP-STN|Duplicate Therapy|02/04/2016| 55111012305|CE:DRO-ATORV40|Drug Regimen Optimization|01/31/2011| 55111012390|CE:DRO-ATORV40|Drug Regimen Optimization|01/31/2011| 55111012390|CE:DUP-STN|Duplicate Therapy|02/04/2016| 55111012405|CE:DUP-STN|Duplicate Therapy|02/04/2016| 55111012490|CE:DUP-STN|Duplicate Therapy|02/04/2016| 55111015701|CE:DRO-OMP10|Drug Regimen Optimization|01/31/2011| 55111015730|CE:DRO-OMP10|Drug Regimen Optimization|01/31/2011| 55111015801|CE:DRO-OMP20|Drug Regimen Optimization|01/31/2011| 55111015810|CE:DRO-OMP20|Drug Regimen Optimization|01/31/2011| 55111015830|CE:DRO-OMP20|Drug Regimen Optimization|01/31/2011| 55111016305|CE:APY-SGA|Antipsychotics|04/10/2016| 55111016305|CE:DRO-OLANZ2.5|Drug Regimen Optimization|01/31/2011| 55111016330|CE:APY-SGA|Antipsychotics|04/10/2016| 55111016330|CE:DRO-OLANZ2.5|Drug Regimen Optimization|01/31/2011| 55111016705|CE:APY-SGA|Antipsychotics|04/10/2016| 55111016730|CE:APY-SGA|Antipsychotics|04/10/2016| 55111016805|CE:APY-SGA|Antipsychotics|04/10/2016| 55111016830|CE:APY-SGA|Antipsychotics|04/10/2016| 55111017001|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 55111017005|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 55111019705|CE:DUP-STN|Duplicate Therapy|02/04/2016| 55111019705|CE:DRO-SIMVA5|Drug Regimen Optimization|01/31/2011| 55111019730|CE:DUP-STN|Duplicate Therapy|02/04/2016| 55111019730|CE:DRO-SIMVA5|Drug Regimen Optimization|01/31/2011| 55111019790|CE:DRO-SIMVA5|Drug Regimen Optimization|01/31/2011| 55111019790|CE:DUP-STN|Duplicate Therapy|02/04/2016| 55111019805|CE:DUP-STN|Duplicate Therapy|02/04/2016| 55111019805|CE:DRO-SIMVA10|Drug Regimen Optimization|01/31/2011| 55111019830|CE:DRO-SIMVA10|Drug Regimen Optimization|01/31/2011| 55111019830|CE:DUP-STN|Duplicate Therapy|02/04/2016| 55111019890|CE:DRO-SIMVA10|Drug Regimen Optimization|01/31/2011| 55111019890|CE:DUP-STN|Duplicate Therapy|02/04/2016| 55111019905|CE:DUP-STN|Duplicate Therapy|02/04/2016| 55111019905|CE:DRO-SIMVA20|Drug Regimen Optimization|01/31/2011| 55111019930|CE:DRO-SIMVA20|Drug Regimen Optimization|01/31/2011| 55111019930|CE:DUP-STN|Duplicate Therapy|02/04/2016| 55111019990|CE:DRO-SIMVA20|Drug Regimen Optimization|01/31/2011| 55111019990|CE:DUP-STN|Duplicate Therapy|02/04/2016| 55111020005|CE:DRO-SIMVA40|Drug Regimen Optimization|01/31/2011| 55111020005|CE:DUP-STN|Duplicate Therapy|02/04/2016| 55111020030|CE:DUP-STN|Duplicate Therapy|02/04/2016| 55111020030|CE:DRO-SIMVA40|Drug Regimen Optimization|01/31/2011| 55111020090|CE:DRO-SIMVA40|Drug Regimen Optimization|01/31/2011| 55111020090|CE:DUP-STN|Duplicate Therapy|02/04/2016| 55111022905|CE:DUP-STN|Duplicate Therapy|02/04/2016| 55111022905|CE:DRO-PRAVA10|Drug Regimen Optimization|01/31/2011| 55111022990|CE:DRO-PRAVA10|Drug Regimen Optimization|01/31/2011| 55111022990|CE:DUP-STN|Duplicate Therapy|02/04/2016| 55111023005|CE:DRO-PRAVA20|Drug Regimen Optimization|01/31/2011| 55111023005|CE:DUP-STN|Duplicate Therapy|02/04/2016| 55111023090|CE:DRO-PRAVA20|Drug Regimen Optimization|01/31/2011| 55111023090|CE:DUP-STN|Duplicate Therapy|02/04/2016| 55111023105|CE:DRO-PRAVA40|Drug Regimen Optimization|01/31/2011| 55111023105|CE:DUP-STN|Duplicate Therapy|02/04/2016| 55111023190|CE:DUP-STN|Duplicate Therapy|02/04/2016| 55111023190|CE:DRO-PRAVA40|Drug Regimen Optimization|01/31/2011| 55111025660|CE:APY-SGA|Antipsychotics|04/10/2016| 55111025760|CE:APY-SGA|Antipsychotics|04/10/2016| 55111025860|CE:APY-SGA|Antipsychotics|04/10/2016| 55111025960|CE:APY-SGA|Antipsychotics|04/10/2016| 55111026281|CE:DRO-OLAODT5|Drug Regimen Optimization|01/31/2011| 55111026281|CE:APY-SGA|Antipsychotics|04/10/2016| 55111026381|CE:DRO-OLAODT10|Drug Regimen Optimization|01/31/2011| 55111026381|CE:APY-SGA|Antipsychotics|04/10/2016| 55111026481|CE:APY-SGA|Antipsychotics|04/10/2016| 55111026581|CE:APY-SGA|Antipsychotics|04/10/2016| 55111026805|CE:DUP-STN|Duplicate Therapy|02/04/2016| 55111026830|CE:DUP-STN|Duplicate Therapy|02/04/2016| 55111026890|CE:DUP-STN|Duplicate Therapy|02/04/2016| 55111027405|CE:DUP-STN|Duplicate Therapy|02/04/2016| 55111027490|CE:DUP-STN|Duplicate Therapy|02/04/2016| 55111028960|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 55111032890|CE:DUP-MGL|Duplicate Therapy|02/05/2013| 55111032990|CE:DUP-MGL|Duplicate Therapy|02/05/2013| 55111033290|CE:DRO-PNZ20|Drug Regimen Optimization|01/31/2011| 55111035605|CE:DRO-DONEZ5|Drug Regimen Optimization|01/31/2011| 55111035610|CE:DRO-DONEZ5|Drug Regimen Optimization|01/31/2011| 55111036031|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 55111039830|CE:DRO-LPZ15|Drug Regimen Optimization|01/31/2011| 55111039890|CE:DRO-LPZ15|Drug Regimen Optimization|01/31/2011| 55111047801|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 55111047901|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 55111049230|CE:DRO-EMP20|Drug Regimen Optimization|01/31/2011| 55111051930|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 55111052030|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 55111052130|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 55111052230|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 55111052830|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 55111053301|CE:DRO-DIVAL250|Drug Regimen Optimization|01/31/2011| 55111053305|CE:DRO-DIVAL250|Drug Regimen Optimization|01/31/2011| 55111055131|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 55111056330|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 55111056430|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 55111061701|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 55111061901|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 55111062560|CE:LTMC-ZAF|Leukotriene Modifiers - Clinical|12/15/2015| 55111062660|CE:LTMC-ZAF|Leukotriene Modifiers - Clinical|12/15/2015| 55111062930|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 55111065001|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 55111065001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 55111067802|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 55111067810|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 55111067902|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 55111067910|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 55111068002|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 55111068010|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 55111068102|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 55111068110|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 55111068201|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 55111068205|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 55111068301|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 55111068305|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 55111068401|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 55111068405|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 55111069990|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 55111070160|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 55111072510|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 55111072530|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 55111072590|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 55111076303|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 55111078401|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 55111079818|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 55111079818|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 55111079836|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 55111079836|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 55111079924|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 55111079924|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 55253080130|CE:MOD-MOD|Modafinil (Provigil)|11/06/2012| 55253080130|CE:MOD-MOD|Modafinil (Provigil)|11/08/2012| 55253080190|CE:MOD-MOD|Modafinil (Provigil)|11/06/2012| 55253080190|CE:MOD-MOD|Modafinil (Provigil)|11/08/2012| 55253080230|CE:MOD-MOD|Modafinil (Provigil)|11/06/2012| 55253080230|CE:MOD-MOD|Modafinil (Provigil)|11/08/2012| 55253080290|CE:MOD-MOD|Modafinil (Provigil)|11/06/2012| 55253080290|CE:MOD-MOD|Modafinil (Provigil)|11/08/2012| 55292010401|CE:ADD-IRMETHAM|ADD/ADHD Agents|02/13/2014| 55292030401|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 55292030401|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 55292030401|CE:ASH-CLORAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 55292030401|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 55513000204|CE:ESP-ARA|Erythropoiesis Stimulating Proteins|09/24/2013| 55513000304|CE:ESP-ARA|Erythropoiesis Stimulating Proteins|09/24/2013| 55513000404|CE:ESP-ARA|Erythropoiesis Stimulating Proteins|09/24/2013| 55513000504|CE:ESP-ARA|Erythropoiesis Stimulating Proteins|09/24/2013| 55513000601|CE:ESP-ARA|Erythropoiesis Stimulating Proteins|09/24/2013| 55513002104|CE:ESP-ARA|Erythropoiesis Stimulating Proteins|09/24/2013| 55513002304|CE:ESP-ARA|Erythropoiesis Stimulating Proteins|09/24/2013| 55513002504|CE:ESP-ARA|Erythropoiesis Stimulating Proteins|09/24/2013| 55513002704|CE:ESP-ARA|Erythropoiesis Stimulating Proteins|09/24/2013| 55513002801|CE:ESP-ARA|Erythropoiesis Stimulating Proteins|09/24/2013| 55513003201|CE:ESP-ARA|Erythropoiesis Stimulating Proteins|09/24/2013| 55513005704|CE:ESP-ARA|Erythropoiesis Stimulating Proteins|09/24/2013| 55513011101|CE:ESP-ARA|Erythropoiesis Stimulating Proteins|09/24/2013| 55513012601|CE:ESP-ESA|Erythropoiesis Stimulating Proteins|09/24/2013| 55513012610|CE:ESP-ESA|Erythropoiesis Stimulating Proteins|09/24/2013| 55513013760|CE:CYC-OTEZ|Cytokine and CAM Antagonists|03/27/2018| 55513014401|CE:ESP-ESA|Erythropoiesis Stimulating Proteins|09/24/2013| 55513014410|CE:ESP-ESA|Erythropoiesis Stimulating Proteins|09/24/2013| 55513014801|CE:ESP-ESA|Erythropoiesis Stimulating Proteins|09/24/2013| 55513014810|CE:ESP-ESA|Erythropoiesis Stimulating Proteins|09/24/2013| 55513026701|CE:ESP-ESA|Erythropoiesis Stimulating Proteins|09/24/2013| 55513026710|CE:ESP-ESA|Erythropoiesis Stimulating Proteins|09/24/2013| 55513028301|CE:ESP-ESA|Erythropoiesis Stimulating Proteins|09/24/2013| 55513028310|CE:ESP-ESA|Erythropoiesis Stimulating Proteins|09/24/2013| 55513036955|CE:CYC-OTEZSP|Cytokine and CAM Antagonists|11/20/2019| 55513036955|CE:CYC-OTEZ|Cytokine and CAM Antagonists|03/27/2018| 55513047801|CE:ESP-ESA|Erythropoiesis Stimulating Proteins|09/24/2013| 55513047810|CE:ESP-ESA|Erythropoiesis Stimulating Proteins|09/24/2013| 55566220000|CE:DES-DESMOINJ|Desmopressin|05/25/2012| 55566230000|CE:DES-DESMOINJ|Desmopressin|05/25/2012| 55566260000|CE:DES-DESMO|Desmopressin|05/25/2012| 55566270000|CE:DES-DESMO|Desmopressin|05/25/2012| 55700014730|CE:SUB-SUBOX|Suboxone|04/23/2013| 55700014730|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 55700014730|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 55700030230|CE:STX-STX|Subutex (buprenorphine)|12/05/2014| 55700030230|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 55700030230|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 55700030330|CE:STX-STX|Subutex (buprenorphine)|12/05/2014| 55700030330|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 55700030330|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 55724021121|CE:TIM-EUC|Topical Immunomodulators ( Elidel & Protopic)|06/06/2017| 57237000201|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 57237000205|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 57237000299|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 57237000705|CE:DRO-MIRTA7.5|Drug Regimen Optimization|01/31/2011| 57237000730|CE:DRO-MIRTA7.5|Drug Regimen Optimization|01/31/2011| 57237000805|CE:DRO-MIRTZA15|Drug Regimen Optimization|01/31/2011| 57237000830|CE:DRO-MIRTZA15|Drug Regimen Optimization|01/31/2011| 57237001106|CE:DRO-MIRODT15|Drug Regimen Optimization|01/31/2011| 57237005060|CE:DRO-GALANT8|Drug Regimen Optimization|01/31/2011| 57237008901|CE:DRO-TRANDOL1|Drug Regimen Optimization|01/31/2011| 57237009001|CE:DRO-TRANDOL2|Drug Regimen Optimization|01/31/2011| 57237010801|CE:DRO-FLP2.5|Drug Regimen Optimization|01/31/2011|01/31/2022 57237010901|CE:DRO-FLP5|Drug Regimen Optimization|01/31/2011|01/31/2022 57237011901|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 57237011999|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 57237012001|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 57237012099|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 57237012101|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 57237012199|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 57237012201|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 57237012299|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 57237012301|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 57237012399|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 57237012401|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 57237012499|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 57237012501|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 57237012601|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 57237012701|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 57237015430|CE:MOD-MOD|Modafinil (Provigil)|11/08/2012| 57237015430|CE:MOD-MOD|Modafinil (Provigil)|11/06/2012| 57237015490|CE:MOD-MOD|Modafinil (Provigil)|11/06/2012| 57237015490|CE:MOD-MOD|Modafinil (Provigil)|11/08/2012| 57237015530|CE:MOD-MOD|Modafinil (Provigil)|11/08/2012| 57237015530|CE:MOD-MOD|Modafinil (Provigil)|11/06/2012| 57237015590|CE:MOD-MOD|Modafinil (Provigil)|11/06/2012| 57237015590|CE:MOD-MOD|Modafinil (Provigil)|11/08/2012| 57237015701|CE:DUP-MGL|Duplicate Therapy|02/05/2013| 57237015801|CE:DUP-MGL|Duplicate Therapy|02/05/2013| 57237015901|CE:DUP-MGL|Duplicate Therapy|02/05/2013| 57237016130|CE:DRO-OMP20|Drug Regimen Optimization|01/31/2011| 57237016190|CE:DRO-OMP20|Drug Regimen Optimization|01/31/2011| 57237016199|CE:DRO-OMP20|Drug Regimen Optimization|01/31/2011| 57237016805|CE:DRO-ROSUV5|Drug Regimen Optimization|01/31/2011| 57237016805|CE:DUP-STN|Duplicate Therapy|02/04/2016| 57237016890|CE:DUP-STN|Duplicate Therapy|02/04/2016| 57237016890|CE:DRO-ROSUV5|Drug Regimen Optimization|01/31/2011| 57237016990|CE:DRO-ROSUV10|Drug Regimen Optimization|01/31/2011| 57237016990|CE:DUP-STN|Duplicate Therapy|02/04/2016| 57237016999|CE:DUP-STN|Duplicate Therapy|02/04/2016| 57237016999|CE:DRO-ROSUV10|Drug Regimen Optimization|01/31/2011| 57237017090|CE:DRO-ROSUV20|Drug Regimen Optimization|01/31/2011| 57237017090|CE:DUP-STN|Duplicate Therapy|02/04/2016| 57237017099|CE:DUP-STN|Duplicate Therapy|02/04/2016| 57237017099|CE:DRO-ROSUV20|Drug Regimen Optimization|01/31/2011| 57237017105|CE:DUP-STN|Duplicate Therapy|02/04/2016| 57237017130|CE:DUP-STN|Duplicate Therapy|02/04/2016| 57237017190|CE:DUP-STN|Duplicate Therapy|02/04/2016| 57237017301|CE:DRO-VENL37.5|Drug Regimen Optimization|01/31/2011| 57237021230|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 57237021290|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 57237021330|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 57237021390|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 57237021760|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 57237021860|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 57237021905|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 57237021930|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 57237021990|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 57237022005|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 57237022030|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 57237022090|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 57237022105|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 57237022130|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 57237022190|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 57237022201|CE:DRO-RAMI1.25|Drug Regimen Optimization|01/31/2011| 57237022230|CE:DRO-RAMI1.25|Drug Regimen Optimization|01/31/2011| 57237022301|CE:DRO-RAMI2.50|Drug Regimen Optimization|01/31/2011| 57237022305|CE:DRO-RAMI2.50|Drug Regimen Optimization|01/31/2011| 57237022401|CE:DRO-RAMI5.00|Drug Regimen Optimization|01/31/2011| 57237022405|CE:DRO-RAMI5.00|Drug Regimen Optimization|01/31/2011| 57237023901|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 57237024001|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 57237026601|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57237026601|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011| 57237026601|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57664005513|CE:DRO-AMLOD2.5|Drug Regimen Optimization|01/31/2011| 57664005518|CE:DRO-AMLOD2.5|Drug Regimen Optimization|01/31/2011| 57664005599|CE:DRO-AMLOD2.5|Drug Regimen Optimization|01/31/2011| 57664005613|CE:DRO-AMLOD5|Drug Regimen Optimization|01/31/2011| 57664005618|CE:DRO-AMLOD5|Drug Regimen Optimization|01/31/2011| 57664005699|CE:DRO-AMLOD5|Drug Regimen Optimization|01/31/2011| 57664010788|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 57664010818|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 57664010888|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 57664010988|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 57664012613|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 57664012613|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57664012613|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57664012613|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 57664012688|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57664012688|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 57664012688|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57664012688|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 57664013388|CE:CCC-CCCC|Cough and Cold Agents - Clinical|12/15/2015| 57664013488|CE:CCC-CCCC|Cough and Cold Agents - Clinical|12/15/2015| 57664017013|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 57664017013|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57664017013|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 57664017013|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57664017088|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 57664017088|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57664017088|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57664017088|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 57664017613|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57664017613|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 57664017613|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57664017613|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 57664017688|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57664017688|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 57664017688|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 57664017688|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57664018788|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 57664018788|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57664018788|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 57664018788|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57664022388|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 57664022388|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57664022388|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 57664022388|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57664022488|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57664022488|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 57664022488|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 57664022488|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57664022888|CE:ADD-IRMETHYL|ADD/ADHD Agents|02/13/2014| 57664022988|CE:ADD-IRMETHYL|ADD/ADHD Agents|02/13/2014| 57664023088|CE:ADD-IRMETHYL|ADD/ADHD Agents|02/13/2014| 57664024188|CE:APY-SGA|Antipsychotics|04/10/2016| 57664033688|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 57664033688|CE:DRO-APHXL5|Drug Regimen Optimization|01/31/2011| 57664033788|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 57664033788|CE:DRO-APHXL10|Drug Regimen Optimization|01/31/2011| 57664033888|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 57664033888|CE:DRO-APHXK15|Drug Regimen Optimization|01/31/2011| 57664033988|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 57664034088|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 57664034188|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 57664034588|CE:APY-SGA|Antipsychotics|04/10/2016| 57664034713|CE:APY-SGA|Antipsychotics|04/10/2016| 57664034788|CE:APY-SGA|Antipsychotics|04/10/2016| 57664037688|CE:ADD-IRFOC|ADD/ADHD Agents|02/13/2014| 57664037708|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57664037708|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57664037708|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 57664037708|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 57664037713|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57664037713|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 57664037713|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57664037713|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 57664037718|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 57664037718|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57664037718|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 57664037718|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57664037888|CE:ADD-IRFOC|ADD/ADHD Agents|02/13/2014| 57664037988|CE:ADD-IRFOC|ADD/ADHD Agents|02/13/2014| 57664039388|CE:DRO-VENL37.5|Drug Regimen Optimization|01/31/2011| 57664049918|CE:DRO-MIRTZA15|Drug Regimen Optimization|01/31/2011| 57664049983|CE:DRO-MIRTZA15|Drug Regimen Optimization|01/31/2011| 57664050818|CE:DRO-CTP20|Drug Regimen Optimization|01/31/2011| 57664053713|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57664053713|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 57664053713|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57664053713|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 57664053718|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 57664053718|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57664053718|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57664053718|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 57664053788|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57664053788|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 57664053788|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 57664053788|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57664066383|CE:DRO-CARVCR10|Drug Regimen Optimization|01/31/2011| 57664066483|CE:DRO-CARVCR20|Drug Regimen Optimization|01/31/2011| 57664066583|CE:DRO-CARVCR40|Drug Regimen Optimization|01/31/2011| 57664075583|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 57664075683|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 57664075683|CE:DRO-OLMES20|Drug Regimen Optimization|01/31/2011| 57664075699|CE:DRO-OLMES20|Drug Regimen Optimization|01/31/2011| 57664075699|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 57664075783|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 57664075799|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 57664075883|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 57664075883|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 57664075899|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 57664075899|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 57664075983|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 57664075983|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 57664075999|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 57664075999|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 57664076083|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 57664076083|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 57664076099|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 57664076099|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 57664077283|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 57664077299|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 57664077383|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 57664077399|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 57664077483|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 57664077499|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 57664077583|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 57664077599|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 57664078386|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57664078386|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57664078386|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57664078386|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 57664078486|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57664078486|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 57664078486|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57664078486|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57664078586|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57664078586|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57664078586|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57664078586|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 57664078686|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57664078686|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57664078686|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 57664078686|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57664078786|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 57664078786|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57664078786|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57664078786|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 57664079683|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 57664079683|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 57664079699|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 57664079699|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 57664079783|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 57664079783|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 57664079799|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 57664079799|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 57664079883|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 57664079883|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 57664079899|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 57664079899|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 57664079983|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 57664079983|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 57664079999|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 57664079999|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 57664080083|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 57664080083|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 57664080099|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 57664080099|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 57665000201|CE:ENZ-ARE|Enzymes|11/20/2019| 57841130001|CE:GIM-MOV|GI Motility|01/18/2017| 57841130101|CE:GIM-MOV|GI Motility|01/18/2017| 57841130103|CE:GIM-MOV|GI Motility|01/18/2017| 57844010501|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 57844011001|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 57844011201|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 57844011501|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 57844011701|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 57844012001|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 57844013001|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 57894006002|CE:CYC-STEL|Cytokine and CAM Antagonists|03/27/2018| 57894006003|CE:CYC-STEL|Cytokine and CAM Antagonists|03/27/2018| 57894006103|CE:CYC-STEL|Cytokine and CAM Antagonists|03/27/2018| 57894007001|CE:CYC-SIMP|Cytokine and CAM Antagonists|03/27/2018| 57894007002|CE:CYC-SIMP|Cytokine and CAM Antagonists|03/27/2018| 57894007101|CE:CYC-SIMP|Cytokine and CAM Antagonists|03/27/2018| 57894007102|CE:CYC-SIMP|Cytokine and CAM Antagonists|03/27/2018| 57894035001|CE:CYC-SIMP|Cytokine and CAM Antagonists|03/27/2018| 57894064001|CE:CYC-TREM|Cytokine and CAM Antagonists|03/27/2018| 57894064011|CE:CYC-TREM|Cytokine and CAM Antagonists|03/27/2018| 58406001004|CE:CYC-ENBR|Cytokine and CAM Antagonists|03/27/2018| 58406002104|CE:CYC-ENBR|Cytokine and CAM Antagonists|03/27/2018| 58406003204|CE:CYC-ENBR|Cytokine and CAM Antagonists|03/27/2018| 58406004401|CE:CYC-ENBR|Cytokine and CAM Antagonists|03/27/2018| 58406004404|CE:CYC-ENBR|Cytokine and CAM Antagonists|03/27/2018| 58406042534|CE:CYC-ENBR|Cytokine and CAM Antagonists|03/27/2018| 58406043501|CE:CYC-ENBR|Cytokine and CAM Antagonists|03/27/2018|03/01/2022 58406043504|CE:CYC-ENBR|Cytokine and CAM Antagonists|03/27/2018|03/01/2022 58406044504|CE:CYC-ENBR|Cytokine and CAM Antagonists|03/27/2018|04/01/2022 58406045501|CE:CYC-ENBR|Cytokine and CAM Antagonists|03/27/2018|10/01/2021 58406045504|CE:CYC-ENBR|Cytokine and CAM Antagonists|03/27/2018|10/01/2021 58406045601|CE:CYC-ENBR|Cytokine and CAM Antagonists|03/27/2018|12/01/2021 58406045604|CE:CYC-ENBR|Cytokine and CAM Antagonists|03/27/2018|12/01/2021 58407062530|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 58407062530|CE:CCC-CCCA|Cough and Cold Agents - Clinical|12/15/2015| 58468004001|CE:ENZ-FAB|Enzymes|11/20/2019| 58468004101|CE:ENZ-FAB|Enzymes|11/20/2019| 58468007001|CE:ENZ-ALD|Enzymes|11/20/2019| 58468016001|CE:ENZ-LUM|Enzymes|11/20/2019| 58468016002|CE:ENZ-LUM|Enzymes|11/20/2019| 58657050004|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 58657050004|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 58657050004|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 58657050004|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 58657050016|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 58657050016|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 58657050016|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 58657050016|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 58657053530|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013|11/30/2020 58657062001|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011|02/28/2021 58657062050|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011|02/28/2021 58657062101|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011|01/31/2021 58657062150|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011|02/28/2021 58657062201|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011|02/28/2021 58657062250|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011|11/30/2020 58657062301|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011|12/31/2020 58657062350|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011|12/31/2020 58657062401|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011|01/31/2021 58657062450|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011|02/28/2021 58657064501|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 58657064501|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 58657064501|CE:CCA-LDCARIS|Carisoprodol Containing Agents|01/31/2011| 58657064510|CE:CCA-LDCARIS|Carisoprodol Containing Agents|01/31/2011| 58657064510|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 58657064510|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 58657064550|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 58657064550|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 58657064550|CE:CCA-LDCARIS|Carisoprodol Containing Agents|01/31/2011| 58657070001|CE:APY-FGA|Antipsychotics|04/10/2016| 58657070101|CE:APY-FGA|Antipsychotics|04/10/2016| 58657070201|CE:APY-FGA|Antipsychotics|04/10/2016| 58657070301|CE:APY-FGA|Antipsychotics|04/10/2016| 58657070310|CE:APY-FGA|Antipsychotics|04/10/2016| 58657070401|CE:APY-FGA|Antipsychotics|04/10/2016| 58657070501|CE:APY-FGA|Antipsychotics|04/10/2016| 58809019860|CE:DXO-DEXDD|Dextromethorphan Overutilization|07/16/2012| 58809019860|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 58809022360|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 58809022360|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 58809048550|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 58809055508|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 58809064330|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 58809065150|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 58809072904|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 58809072904|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 58809074050|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 58809075050|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 58809085008|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 58809099901|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 58809099901|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 59011025630|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011|12/31/2020 59011027160|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 59011027160|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 59011027160|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59011027160|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59011027260|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 59011027260|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 59011027260|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59011027260|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59011027360|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59011027360|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59011027360|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 59011027360|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 59011027460|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59011027460|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 59011027460|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59011027460|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 59011027560|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59011027560|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 59011027560|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 59011027560|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59011027660|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 59011027660|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59011027660|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 59011027660|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59011027760|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59011027760|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 59011027760|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 59011027760|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59011041010|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59011041010|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 59011041010|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 59011041010|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59011041010|CE:OXC-LD OXY|Oxycontin (Narcotic Analgesic)|01/31/2011| 59011041510|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59011041510|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 59011041510|CE:OXC-LD OXY|Oxycontin (Narcotic Analgesic)|01/31/2011| 59011041510|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59011041510|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 59011042010|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59011042010|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 59011042010|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 59011042010|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59011042010|CE:OXC-LD OXY|Oxycontin (Narcotic Analgesic)|01/31/2011| 59011043010|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59011043010|CE:OXC-LD OXY|Oxycontin (Narcotic Analgesic)|01/31/2011| 59011043010|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 59011043010|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59011043010|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 59011044010|CE:OXC-LD OXY|Oxycontin (Narcotic Analgesic)|01/31/2011| 59011044010|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 59011044010|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59011044010|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 59011044010|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59011046010|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 59011046010|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59011046010|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59011046010|CE:OXC-HD OXY|Oxycontin (Narcotic Analgesic)|01/31/2011| 59011046010|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 59011048010|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 59011048010|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59011048010|CE:OXC-HD OXY|Oxycontin (Narcotic Analgesic)|01/31/2011| 59011048010|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 59011048010|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59011075004|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 59011075004|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 59011075004|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59011075004|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59011075104|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59011075104|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 59011075104|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59011075104|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 59011075204|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59011075204|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59011075204|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 59011075204|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 59011075704|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 59011075704|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59011075704|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59011075804|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59011075804|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 59011075804|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59148000613|CE:APY-ARI|Antipsychotics|04/10/2016| 59148000713|CE:APY-ARI|Antipsychotics|04/10/2016| 59148000713|CE:DRO-ARIPI5|Drug Regimen Optimization|01/31/2011| 59148000813|CE:APY-ARI|Antipsychotics|04/10/2016| 59148000813|CE:DRO-ARIPI10|Drug Regimen Optimization|01/31/2011| 59148000913|CE:DRO-ARIPI15|Drug Regimen Optimization|01/31/2011| 59148000913|CE:APY-ARI|Antipsychotics|04/10/2016| 59148001013|CE:APY-ARI|Antipsychotics|04/10/2016| 59148001113|CE:APY-ARI|Antipsychotics|04/10/2016| 59148001871|CE:APY-SGA|Antipsychotics|04/10/2016| 59148001871|CE:APY-ARI|Antipsychotics|04/10/2016| 59148001971|CE:APY-SGA|Antipsychotics|04/10/2016| 59148001971|CE:APY-ARI|Antipsychotics|04/10/2016| 59148002985|CE:APY-ARI|Antipsychotics|04/10/2016| 59148003085|CE:DRO-ARIPI5|Drug Regimen Optimization|01/31/2011| 59148003085|CE:APY-ARI|Antipsychotics|04/10/2016| 59148003185|CE:DRO-ARIPI10|Drug Regimen Optimization|01/31/2011| 59148003185|CE:APY-ARI|Antipsychotics|04/10/2016| 59148003285|CE:APY-ARI|Antipsychotics|04/10/2016| 59148003285|CE:DRO-ARIPI15|Drug Regimen Optimization|01/31/2011| 59148003385|CE:APY-ARI|Antipsychotics|04/10/2016| 59148003485|CE:APY-ARI|Antipsychotics|04/10/2016| 59148003513|CE:APY-SGA|Antipsychotics|04/10/2016| 59148003613|CE:APY-SGA|Antipsychotics|04/10/2016| 59148003713|CE:APY-SGA|Antipsychotics|04/10/2016| 59148003813|CE:APY-SGA|Antipsychotics|04/10/2016| 59148003913|CE:APY-SGA|Antipsychotics|04/10/2016| 59148004013|CE:APY-SGA|Antipsychotics|04/10/2016| 59148004580|CE:APY-SGA|Antipsychotics|04/10/2016| 59148004580|CE:APY-ARI|Antipsychotics|04/10/2016| 59148007280|CE:APY-ARI|Antipsychotics|04/10/2016| 59148007280|CE:APY-SGA|Antipsychotics|04/10/2016| 59310030240|CE:DUP-CRTROD|Duplicate Therapy|02/05/2013| 59310030480|CE:DUP-CRTROD|Duplicate Therapy|02/05/2013| 59310057922|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 59310058020|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 59385001201|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59385001201|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59385001201|CE:SUB-SUBOX|Suboxone|04/23/2013| 59385001230|CE:SUB-SUBOX|Suboxone|04/23/2013| 59385001230|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59385001230|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59385001401|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59385001401|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59385001401|CE:SUB-SUBOX|Suboxone|04/23/2013| 59385001430|CE:SUB-SUBOX|Suboxone|04/23/2013| 59385001430|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59385001430|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59385001601|CE:SUB-SUBOX|Suboxone|04/23/2013| 59385001601|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59385001601|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59385001630|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59385001630|CE:SUB-SUBOX|Suboxone|04/23/2013| 59385001630|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59385002160|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 59385002160|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 59385002260|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 59385002260|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 59385002360|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 59385002360|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 59385002460|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 59385002460|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 59385002560|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 59385002560|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 59385002660|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 59385002760|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 59385002760|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 59417010110|CE:ADD-ERVYV|ADD/ADHD Agents|02/13/2014| 59417010210|CE:ADD-ERVYV|ADD/ADHD Agents|02/13/2014| 59417010310|CE:ADD-ERVYV|ADD/ADHD Agents|02/13/2014| 59417010410|CE:ADD-ERVYV|ADD/ADHD Agents|02/13/2014| 59417010510|CE:ADD-ERVYV|ADD/ADHD Agents|02/13/2014| 59417010610|CE:ADD-ERVYV|ADD/ADHD Agents|02/13/2014| 59417010710|CE:ADD-ERVYV|ADD/ADHD Agents|02/13/2014| 59417011501|CE:ADD-ERVYV|ADD/ADHD Agents|02/13/2014| 59417011601|CE:ADD-ERVYV|ADD/ADHD Agents|02/13/2014| 59417011701|CE:ADD-ERVYV|ADD/ADHD Agents|02/13/2014| 59417011801|CE:ADD-ERVYV|ADD/ADHD Agents|02/13/2014| 59417011901|CE:ADD-ERVYV|ADD/ADHD Agents|02/13/2014| 59417012001|CE:ADD-ERVYV|ADD/ADHD Agents|02/13/2014| 59572063106|CE:CYC-OTEZ|Cytokine and CAM Antagonists|03/27/2018|10/31/2022 59572063255|CE:CYC-OTEZ|Cytokine and CAM Antagonists|03/27/2018|08/31/2022 59572063255|CE:CYC-OTEZSP|Cytokine and CAM Antagonists|11/20/2019|08/31/2022 59617001502|CE:ALE-ORA|Allergen Extracts (Clinical)|09/01/2015| 59630075050|CE:ADD-IRMETHYL|ADD/ADHD Agents|02/13/2014| 59630075550|CE:ADD-IRMETHYL|ADD/ADHD Agents|02/13/2014| 59651000101|CE:DRO-OMP10|Drug Regimen Optimization|01/31/2011| 59651000130|CE:DRO-OMP10|Drug Regimen Optimization|01/31/2011| 59651000205|CE:DRO-OMP20|Drug Regimen Optimization|01/31/2011| 59651000290|CE:DRO-OMP20|Drug Regimen Optimization|01/31/2011| 59651001890|CE:DRO-NIASA500|Drug Regimen Optimization|01/31/2011| 59651003212|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 59651003247|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 59651004730|CE:MOD-ARM|Modafinil (Provigil)|02/06/2018| 59651011055|CE:APY-ARI|Antipsychotics|04/10/2016| 59651026830|CE:DRO-GLIP2.5|Drug Regimen Optimization|01/31/2011| 59651026901|CE:DRO-GLIP5|Drug Regimen Optimization|01/31/2011| 59651026905|CE:DRO-GLIP5|Drug Regimen Optimization|01/31/2011| 59651032930|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 59676030201|CE:ESP-ESA|Erythropoiesis Stimulating Proteins|09/24/2013| 59676030301|CE:ESP-ESA|Erythropoiesis Stimulating Proteins|09/24/2013| 59676030401|CE:ESP-ESA|Erythropoiesis Stimulating Proteins|09/24/2013| 59676031001|CE:ESP-ESA|Erythropoiesis Stimulating Proteins|09/24/2013| 59676031002|CE:ESP-ESA|Erythropoiesis Stimulating Proteins|09/24/2013| 59676031204|CE:ESP-ESA|Erythropoiesis Stimulating Proteins|09/24/2013| 59676032004|CE:ESP-ESA|Erythropoiesis Stimulating Proteins|09/24/2013| 59676034001|CE:ESP-ESA|Erythropoiesis Stimulating Proteins|09/24/2013| 59746000103|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 59746000103|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 59746000106|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 59746000106|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 59746000204|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 59746000204|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 59746000314|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 59746000314|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 59746001032|CE:DRO-RISODT.5|Drug Regimen Optimization|01/31/2011| 59746001032|CE:APY-ARI|Antipsychotics|04/10/2016| 59746001504|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 59746001504|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 59746002022|CE:APY-ARI|Antipsychotics|04/10/2016| 59746002022|CE:DRO-RISODT1|Drug Regimen Optimization|01/31/2011| 59746003022|CE:DRO-RISODT2|Drug Regimen Optimization|01/31/2011| 59746003022|CE:APY-ARI|Antipsychotics|04/10/2016| 59746004022|CE:APY-ARI|Antipsychotics|04/10/2016| 59746005022|CE:APY-ARI|Antipsychotics|04/10/2016| 59746012106|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 59746012110|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 59746012206|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 59746012210|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 59746017106|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 59746017106|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 59746017110|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 59746017110|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 59746017206|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 59746017206|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 59746017210|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 59746017210|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 59746017306|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 59746017306|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 59746017310|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 59746017310|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 59746017506|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 59746017506|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 59746017509|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 59746017509|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 59746017706|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59746017706|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59746017706|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011| 59746017710|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59746017710|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59746017710|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011| 59746021106|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59746021106|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011| 59746021106|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59746021110|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011| 59746021110|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59746021110|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59746027901|CE:DRO-ETP5|Drug Regimen Optimization|01/31/2011| 59746028001|CE:DRO-ETP10|Drug Regimen Optimization|01/31/2011| 59746028390|CE:DRO-PNZ20|Drug Regimen Optimization|01/31/2011|11/01/2020 59746028532|CE:DRO-CERTIR5|Drug Regimen Optimization|01/31/2011| 59746028532|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 59746028632|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 59746030632|CE:DRO-OLAODT5|Drug Regimen Optimization|01/31/2011| 59746030632|CE:APY-SGA|Antipsychotics|04/10/2016| 59746030732|CE:APY-SGA|Antipsychotics|04/10/2016| 59746030732|CE:DRO-OLAODT10|Drug Regimen Optimization|01/31/2011| 59746030832|CE:APY-SGA|Antipsychotics|04/10/2016| 59746030932|CE:APY-SGA|Antipsychotics|04/10/2016| 59746032930|CE:DRO-DONEZ5|Drug Regimen Optimization|01/31/2011| 59746032990|CE:DRO-DONEZ5|Drug Regimen Optimization|01/31/2011| 59746033310|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 59746033310|CE:DRO-LORSA25|Drug Regimen Optimization|01/31/2011| 59746033390|CE:DRO-LORSA25|Drug Regimen Optimization|01/31/2011| 59746033390|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 59746033410|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 59746033410|CE:DRO-LORSA50|Drug Regimen Optimization|01/31/2011| 59746033430|CE:DRO-LORSA50|Drug Regimen Optimization|01/31/2011| 59746033430|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 59746033490|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 59746033490|CE:DRO-LORSA50|Drug Regimen Optimization|01/31/2011| 59746033510|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 59746033530|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 59746033590|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 59746033730|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 59746033730|CE:DRO-LORS12.5|Drug Regimen Optimization|01/31/2011| 59746033730|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 59746033790|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 59746033790|CE:DRO-LORS12.5|Drug Regimen Optimization|01/31/2011| 59746033790|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 59746033830|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 59746033830|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 59746033890|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 59746033890|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 59746033930|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 59746033930|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 59746033990|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 59746033990|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 59746035830|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015|11/01/2020 59746035890|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015|11/01/2020 59746035930|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015|11/01/2020 59746035990|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015|11/01/2020 59746036030|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 59746036190|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 59746036190|CE:DRO-VALSA80|Drug Regimen Optimization|01/31/2011| 59746036290|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 59746036290|CE:DRO-VALSA160|Drug Regimen Optimization|01/31/2011| 59746036390|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 59746037960|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 59746038206|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 59746038210|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 59746038306|CE:DRO-TERAZO1|Drug Regimen Optimization|01/31/2011| 59746038310|CE:DRO-TERAZO1|Drug Regimen Optimization|01/31/2011| 59746038506|CE:DRO-TERAZO5|Drug Regimen Optimization|01/31/2011| 59746038510|CE:DRO-TERAZO5|Drug Regimen Optimization|01/31/2011| 59746044730|CE:DRO-IRBE75|Drug Regimen Optimization|01/31/2011| 59746044730|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 59746044790|CE:DRO-IRBE75|Drug Regimen Optimization|01/31/2011| 59746044790|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 59746044830|CE:DRO-IRBE150|Drug Regimen Optimization|01/31/2011| 59746044830|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 59746044890|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 59746044890|CE:DRO-IRBE150|Drug Regimen Optimization|01/31/2011| 59746044930|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 59746044990|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 59746070501|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|11/01/2020 59746070501|CE:CCA-LDCARIS|Carisoprodol Containing Agents|01/31/2011|11/01/2020 59746070501|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|11/01/2020 59746070505|CE:CCA-LDCARIS|Carisoprodol Containing Agents|01/31/2011|11/01/2020 59746070505|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|11/01/2020 59746070505|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|11/01/2020 59746070510|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|11/01/2020 59746070510|CE:CCA-LDCARIS|Carisoprodol Containing Agents|01/31/2011|11/01/2020 59746070510|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|11/01/2020 59762002801|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 59762002802|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 59762002901|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 59762003301|CE:SDF-REVATIO|Sildenafil (Revatio)|01/31/2011| 59762004701|CE:DRO-TOLTLA2|Drug Regimen Optimization|01/31/2011| 59762004702|CE:DRO-TOLTLA2|Drug Regimen Optimization|01/31/2011| 59762004901|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 59762004901|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 59762005001|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 59762005001|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 59762005101|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 59762005101|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 59762005701|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762005701|CE:ALP-ALP|Alprazolam|05/28/2015| 59762005701|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762005701|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762005901|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762005901|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762005901|CE:ALP-ALP|Alprazolam|05/28/2015| 59762005901|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762006601|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762006601|CE:ALP-ALP|Alprazolam|05/28/2015| 59762006601|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762006601|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762006801|CE:ALP-ALP|Alprazolam|05/28/2015| 59762006801|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762006801|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762006801|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762007301|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 59762007301|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 59762007401|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 59762007401|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 59762007501|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 59762007501|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 59762014001|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 59762014501|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 59762015501|CE:DRO-ATORV10|Drug Regimen Optimization|01/31/2011| 59762015501|CE:DUP-STN|Duplicate Therapy|02/04/2016| 59762015502|CE:DRO-ATORV10|Drug Regimen Optimization|01/31/2011| 59762015502|CE:DUP-STN|Duplicate Therapy|02/04/2016| 59762015601|CE:DRO-ATORV20|Drug Regimen Optimization|01/31/2011| 59762015601|CE:DUP-STN|Duplicate Therapy|02/04/2016| 59762015602|CE:DRO-ATORV20|Drug Regimen Optimization|01/31/2011| 59762015602|CE:DUP-STN|Duplicate Therapy|02/04/2016| 59762015701|CE:DRO-ATORV40|Drug Regimen Optimization|01/31/2011| 59762015701|CE:DUP-STN|Duplicate Therapy|02/04/2016| 59762015702|CE:DUP-STN|Duplicate Therapy|02/04/2016| 59762015702|CE:DRO-ATORV40|Drug Regimen Optimization|01/31/2011| 59762015801|CE:DUP-STN|Duplicate Therapy|02/04/2016| 59762015802|CE:DUP-STN|Duplicate Therapy|02/04/2016| 59762022001|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 59762022201|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 59762022301|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 59762054001|CE:DRO-GLIP2.5|Drug Regimen Optimization|01/31/2011| 59762054101|CE:DRO-GLIP5|Drug Regimen Optimization|01/31/2011| 59762054102|CE:DRO-GLIP5|Drug Regimen Optimization|01/31/2011| 59762151501|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 59762151501|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 59762151601|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 59762151601|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 59762151603|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 59762151603|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 59762151701|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 59762151701|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 59762151703|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 59762151703|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 59762151802|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 59762151802|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 59762200101|CE:APY-SGA|Antipsychotics|04/10/2016| 59762200201|CE:APY-SGA|Antipsychotics|04/10/2016| 59762200301|CE:APY-SGA|Antipsychotics|04/10/2016| 59762200401|CE:APY-SGA|Antipsychotics|04/10/2016| 59762205801|CE:SDF-REVSUSP|Sildenafil (Revatio)|09/01/2015| 59762231006|CE:DRO-DOXA1|Drug Regimen Optimization|01/31/2011| 59762232006|CE:DRO-DOXA2|Drug Regimen Optimization|01/31/2011| 59762234006|CE:DRO-DOXA4|Drug Regimen Optimization|01/31/2011| 59762371704|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762371704|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762371704|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762371704|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 59762371709|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762371709|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762371709|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762371709|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 59762371803|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762371803|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762371803|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762371803|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 59762371804|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762371804|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 59762371804|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762371804|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762371809|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762371809|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762371809|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762371809|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 59762371901|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762371901|CE:ALP-ALP|Alprazolam|05/28/2015| 59762371901|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762371901|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762371903|CE:ALP-ALP|Alprazolam|05/28/2015| 59762371903|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762371903|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762371903|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762371904|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762371904|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762371904|CE:ALP-ALP|Alprazolam|05/28/2015| 59762371904|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762372001|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762372001|CE:ALP-ALP|Alprazolam|05/28/2015| 59762372001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762372001|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762372003|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762372003|CE:ALP-ALP|Alprazolam|05/28/2015| 59762372003|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762372003|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762372004|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762372004|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762372004|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762372004|CE:ALP-ALP|Alprazolam|05/28/2015| 59762372101|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762372101|CE:ALP-ALP|Alprazolam|05/28/2015| 59762372101|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762372101|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762372103|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762372103|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762372103|CE:ALP-ALP|Alprazolam|05/28/2015| 59762372103|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762372104|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762372104|CE:ALP-ALP|Alprazolam|05/28/2015| 59762372104|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762372104|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762372201|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762372201|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762372201|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762372201|CE:ALP-ALP|Alprazolam|05/28/2015| 59762372203|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762372203|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762372203|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 59762372203|CE:ALP-ALP|Alprazolam|05/28/2015| 59762444002|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 59762444002|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 59762444003|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 59762444003|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 59762501401|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 59762502501|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011|01/14/2021 59762505001|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 59762600201|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 59762634701|CE:DRO-SRL25|Drug Regimen Optimization|01/31/2011| 59762644301|CE:DRO-SRL50|Drug Regimen Optimization|01/31/2011| 59762644302|CE:DRO-SRL50|Drug Regimen Optimization|01/31/2011| 59762644303|CE:DRO-SRL50|Drug Regimen Optimization|01/31/2011| 59762671001|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 59762671101|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 59762671201|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 59762672001|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 59762672101|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 59762672201|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 59762672301|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 59762673001|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 59762673101|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 59762673201|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 59762673301|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 59922063101|CE:FOS-FOSRENOL|Fosrenol (Lanthanum Carbonate)|01/31/2011| 60429058611|CE:SUB-SUBOX|Suboxone|04/23/2013| 60429058611|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60429058611|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60429058630|CE:SUB-SUBOX|Suboxone|04/23/2013| 60429058630|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60429058630|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60429058633|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60429058633|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60429058633|CE:SUB-SUBOX|Suboxone|04/23/2013| 60429058711|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60429058711|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60429058711|CE:SUB-SUBOX|Suboxone|04/23/2013| 60429058730|CE:SUB-SUBOX|Suboxone|04/23/2013| 60429058730|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60429058730|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60429058733|CE:SUB-SUBOX|Suboxone|04/23/2013| 60429058733|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60429058733|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60432015004|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 60432015016|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 60432021208|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 60432021208|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 60432024516|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60432024516|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60432024516|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 60432027504|CE:DXO-DEXQ|Dextromethorphan Overutilization|07/16/2012| 60432027504|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 60432027504|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 60432027516|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 60432027516|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 60432027516|CE:DXO-DEXQ|Dextromethorphan Overutilization|07/16/2012| 60432045516|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60432045516|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 60432045516|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60432045516|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 60432046608|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 60432046608|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 60432060416|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 60432060416|CE:DXO-DEXO|Dextromethorphan Overutilization|07/16/2012| 60432060416|CE:DXO-DEXN|Dextromethorphan Overutilization|07/16/2012| 60432060416|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 60432060416|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 60432060616|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 60432060616|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 60432060616|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 60432060616|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 60432060616|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60432060616|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60432060816|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 60432060816|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 60432070605|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 60432070605|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60432070605|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60432070605|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 60432083704|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013|11/23/2020 60432083704|CE:DXO-DEXQ|Dextromethorphan Overutilization|07/16/2012|11/23/2020 60432083704|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015|11/23/2020 60432083716|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013|11/23/2020 60432083716|CE:DXO-DEXQ|Dextromethorphan Overutilization|07/16/2012|11/23/2020 60432083716|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015|11/23/2020 60505003901|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 60505004001|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 60505004101|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 60505006500|CE:DRO-OMP20|Drug Regimen Optimization|01/31/2011| 60505006501|CE:DRO-OMP20|Drug Regimen Optimization|01/31/2011| 60505006502|CE:DRO-OMP20|Drug Regimen Optimization|01/31/2011| 60505008301|CE:DRO-PRX20|Drug Regimen Optimization|01/31/2011| 60505008302|CE:DRO-PRX20|Drug Regimen Optimization|01/31/2011| 60505008304|CE:DRO-PRX20|Drug Regimen Optimization|01/31/2011| 60505009300|CE:DRO-DOXA1|Drug Regimen Optimization|01/31/2011| 60505009301|CE:DRO-DOXA1|Drug Regimen Optimization|01/31/2011| 60505009400|CE:DRO-DOXA2|Drug Regimen Optimization|01/31/2011| 60505009401|CE:DRO-DOXA2|Drug Regimen Optimization|01/31/2011| 60505009500|CE:DRO-DOXA4|Drug Regimen Optimization|01/31/2011| 60505009501|CE:DRO-DOXA4|Drug Regimen Optimization|01/31/2011| 60505009505|CE:DRO-DOXA4|Drug Regimen Optimization|01/31/2011|10/30/2021 60505009701|CE:DRO-PRX10|Drug Regimen Optimization|01/31/2011| 60505009702|CE:DRO-PRX10|Drug Regimen Optimization|01/31/2011| 60505009704|CE:DRO-PRX10|Drug Regimen Optimization|01/31/2011| 60505010201|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 60505011201|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 60505011208|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 60505011301|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 60505011308|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 60505011401|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 60505011405|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 60505014500|CE:DRO-OMP10|Drug Regimen Optimization|01/31/2011| 60505014501|CE:DRO-OMP10|Drug Regimen Optimization|01/31/2011| 60505014502|CE:DRO-OMP10|Drug Regimen Optimization|01/31/2011| 60505014701|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 60505014708|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 60505016805|CE:DRO-PRAVA10|Drug Regimen Optimization|01/31/2011| 60505016805|CE:DUP-STN|Duplicate Therapy|02/04/2016| 60505016809|CE:DRO-PRAVA10|Drug Regimen Optimization|01/31/2011| 60505016809|CE:DUP-STN|Duplicate Therapy|02/04/2016| 60505016907|CE:DUP-STN|Duplicate Therapy|02/04/2016| 60505016907|CE:DRO-PRAVA20|Drug Regimen Optimization|01/31/2011| 60505016909|CE:DUP-STN|Duplicate Therapy|02/04/2016| 60505016909|CE:DRO-PRAVA20|Drug Regimen Optimization|01/31/2011| 60505017007|CE:DRO-PRAVA40|Drug Regimen Optimization|01/31/2011| 60505017007|CE:DUP-STN|Duplicate Therapy|02/04/2016| 60505017009|CE:DUP-STN|Duplicate Therapy|02/04/2016| 60505017009|CE:DRO-PRAVA40|Drug Regimen Optimization|01/31/2011| 60505020801|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 60505024701|CE:DRO-MIRTZA15|Drug Regimen Optimization|01/31/2011| 60505024708|CE:DRO-MIRTZA15|Drug Regimen Optimization|01/31/2011| 60505025701|CE:DES-DESMO|Desmopressin|05/25/2012| 60505025801|CE:DES-DESMO|Desmopressin|05/25/2012| 60505026101|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 60505026201|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013|08/06/2021 60505026301|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 60505026401|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 60505039905|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 60505040405|CE:APY-ARI|Antipsychotics|04/10/2016| 60505079100|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 60505079104|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 60505079200|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 60505079204|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 60505079300|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 60505079304|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 60505079400|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 60505079404|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 60505079501|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 60505079504|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 60505079600|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 60505079604|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 60505079800|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 60505079804|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 60505081301|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 60505081301|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 60505081301|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60505081301|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60505083305|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 60505084805|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 60505131603|CE:DRO-PRX12.5|Drug Regimen Optimization|01/31/2011| 60505132305|CE:DUP-STN|Duplicate Therapy|02/04/2016| 60505132309|CE:DUP-STN|Duplicate Therapy|02/04/2016| 60505251801|CE:DRO-CTP10|Drug Regimen Optimization|01/31/2011| 60505251804|CE:DRO-CTP10|Drug Regimen Optimization|01/31/2011| 60505251808|CE:DRO-CTP10|Drug Regimen Optimization|01/31/2011| 60505251901|CE:DRO-CTP20|Drug Regimen Optimization|01/31/2011| 60505251904|CE:DRO-CTP20|Drug Regimen Optimization|01/31/2011| 60505251908|CE:DRO-CTP20|Drug Regimen Optimization|01/31/2011| 60505252603|CE:MOD-MOD|Modafinil (Provigil)|11/08/2012| 60505252603|CE:MOD-MOD|Modafinil (Provigil)|11/06/2012| 60505252703|CE:MOD-MOD|Modafinil (Provigil)|11/06/2012| 60505252703|CE:MOD-MOD|Modafinil (Provigil)|11/08/2012| 60505252806|CE:APY-SGA|Antipsychotics|04/10/2016| 60505252906|CE:APY-SGA|Antipsychotics|04/10/2016| 60505253006|CE:APY-SGA|Antipsychotics|04/10/2016| 60505253106|CE:APY-SGA|Antipsychotics|04/10/2016| 60505254306|CE:DRO-GALANT8|Drug Regimen Optimization|01/31/2011| 60505255101|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 60505255105|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 60505255201|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 60505255205|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 60505257808|CE:DRO-ATORV10|Drug Regimen Optimization|01/31/2011| 60505257808|CE:DUP-STN|Duplicate Therapy|02/04/2016| 60505257809|CE:DUP-STN|Duplicate Therapy|02/04/2016| 60505257809|CE:DRO-ATORV10|Drug Regimen Optimization|01/31/2011| 60505257908|CE:DUP-STN|Duplicate Therapy|02/04/2016| 60505257908|CE:DRO-ATORV20|Drug Regimen Optimization|01/31/2011| 60505257909|CE:DUP-STN|Duplicate Therapy|02/04/2016| 60505257909|CE:DRO-ATORV20|Drug Regimen Optimization|01/31/2011| 60505258008|CE:DRO-ATORV40|Drug Regimen Optimization|01/31/2011| 60505258008|CE:DUP-STN|Duplicate Therapy|02/04/2016| 60505258009|CE:DRO-ATORV40|Drug Regimen Optimization|01/31/2011| 60505258009|CE:DUP-STN|Duplicate Therapy|02/04/2016| 60505263301|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 60505263308|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 60505264401|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 60505264401|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60505264401|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60505264401|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 60505264405|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60505264405|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 60505264405|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 60505264405|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60505265601|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 60505265605|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 60505265701|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 60505265705|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 60505267108|CE:DUP-STN|Duplicate Therapy|02/04/2016| 60505267109|CE:DUP-STN|Duplicate Therapy|02/04/2016| 60505267303|CE:APY-ARI|Antipsychotics|04/10/2016| 60505267303|CE:DRO-ARIPI5|Drug Regimen Optimization|01/31/2011| 60505267403|CE:APY-ARI|Antipsychotics|04/10/2016| 60505267403|CE:DRO-ARIPI10|Drug Regimen Optimization|01/31/2011| 60505267503|CE:DRO-ARIPI15|Drug Regimen Optimization|01/31/2011| 60505267503|CE:APY-ARI|Antipsychotics|04/10/2016| 60505267603|CE:APY-ARI|Antipsychotics|04/10/2016| 60505267703|CE:APY-ARI|Antipsychotics|04/10/2016| 60505278001|CE:DRO-ETP5|Drug Regimen Optimization|01/31/2011| 60505278008|CE:DRO-ETP5|Drug Regimen Optimization|01/31/2011| 60505278101|CE:DRO-ETP10|Drug Regimen Optimization|01/31/2011| 60505278108|CE:DRO-ETP10|Drug Regimen Optimization|01/31/2011| 60505283003|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 60505283103|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 60505283203|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 60505283303|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 60505283403|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 60505283503|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 60505283603|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 60505307503|CE:APY-ARI|Antipsychotics|04/10/2016| 60505311003|CE:DRO-OLANZ2.5|Drug Regimen Optimization|01/31/2011| 60505311003|CE:APY-SGA|Antipsychotics|04/10/2016| 60505311008|CE:APY-SGA|Antipsychotics|04/10/2016| 60505311008|CE:DRO-OLANZ2.5|Drug Regimen Optimization|01/31/2011| 60505311103|CE:APY-SGA|Antipsychotics|04/10/2016|04/02/2021 60505311103|CE:DRO-OLANZ5|Drug Regimen Optimization|01/31/2011|04/02/2021 60505311108|CE:APY-SGA|Antipsychotics|04/10/2016| 60505311108|CE:DRO-OLANZ5|Drug Regimen Optimization|01/31/2011| 60505311203|CE:APY-SGA|Antipsychotics|04/10/2016|04/02/2021 60505311203|CE:DRO-OLANZ7.5|Drug Regimen Optimization|01/31/2011|04/02/2021 60505311208|CE:APY-SGA|Antipsychotics|04/10/2016| 60505311208|CE:DRO-OLANZ7.5|Drug Regimen Optimization|01/31/2011| 60505311303|CE:DRO-OLANZ10|Drug Regimen Optimization|01/31/2011|04/02/2021 60505311303|CE:APY-SGA|Antipsychotics|04/10/2016|04/02/2021 60505311308|CE:DRO-OLANZ10|Drug Regimen Optimization|01/31/2011| 60505311308|CE:APY-SGA|Antipsychotics|04/10/2016| 60505311403|CE:APY-SGA|Antipsychotics|04/10/2016| 60505311408|CE:APY-SGA|Antipsychotics|04/10/2016| 60505313001|CE:APY-SGA|Antipsychotics|04/10/2016| 60505313008|CE:APY-SGA|Antipsychotics|04/10/2016| 60505313201|CE:APY-SGA|Antipsychotics|04/10/2016| 60505313208|CE:APY-SGA|Antipsychotics|04/10/2016| 60505313301|CE:APY-SGA|Antipsychotics|04/10/2016| 60505313308|CE:APY-SGA|Antipsychotics|04/10/2016| 60505313501|CE:APY-SGA|Antipsychotics|04/10/2016| 60505313508|CE:APY-SGA|Antipsychotics|04/10/2016| 60505313706|CE:APY-SGA|Antipsychotics|04/10/2016| 60505313901|CE:APY-SGA|Antipsychotics|04/10/2016| 60505314003|CE:APY-SGA|Antipsychotics|04/10/2016| 60505314008|CE:APY-SGA|Antipsychotics|04/10/2016| 60505317007|CE:LVZ-LOVAZ|Lovaza|07/16/2012| 60505327500|CE:DRO-OLAODT5|Drug Regimen Optimization|01/31/2011| 60505327500|CE:APY-SGA|Antipsychotics|04/10/2016| 60505327503|CE:APY-SGA|Antipsychotics|04/10/2016| 60505327503|CE:DRO-OLAODT5|Drug Regimen Optimization|01/31/2011| 60505327600|CE:DRO-OLAODT10|Drug Regimen Optimization|01/31/2011| 60505327600|CE:APY-SGA|Antipsychotics|04/10/2016| 60505327603|CE:APY-SGA|Antipsychotics|04/10/2016| 60505327603|CE:DRO-OLAODT10|Drug Regimen Optimization|01/31/2011| 60505327700|CE:APY-SGA|Antipsychotics|04/10/2016| 60505327703|CE:APY-SGA|Antipsychotics|04/10/2016| 60505327800|CE:APY-SGA|Antipsychotics|04/10/2016| 60505327803|CE:APY-SGA|Antipsychotics|04/10/2016| 60505340909|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 60505360303|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 60505360303|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 60505360309|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 60505360309|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 60505360403|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 60505360403|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 60505366303|CE:DRO-PRX10|Drug Regimen Optimization|01/31/2011| 60505366403|CE:DRO-PRX20|Drug Regimen Optimization|01/31/2011|10/31/2020 60505366803|CE:DRO-PRX12.5|Drug Regimen Optimization|01/31/2011| 60505367303|CE:DRO-PRX12.5|Drug Regimen Optimization|01/31/2011| 60505367803|CE:DRO-CARVCR10|Drug Regimen Optimization|01/31/2011| 60505367903|CE:DRO-CARVCR20|Drug Regimen Optimization|01/31/2011| 60505368003|CE:DRO-CARVCR40|Drug Regimen Optimization|01/31/2011| 60505371309|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 60505380709|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 60505380709|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 60505380809|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 60505380809|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 60505380909|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 60505380909|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 60505384706|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 60505384706|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 60505384801|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 60505384801|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 60505384805|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 60505384805|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 60505384901|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 60505384901|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 60505384905|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 60505384905|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 60505388207|CE:VMAT-TET|VMAT2 Inhibitors|09/25/2018| 60505388307|CE:VMAT-TET|VMAT2 Inhibitors|09/25/2018| 60505392701|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 60505392801|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 60505392901|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 60505393001|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 60505395203|CE:DRO-OMP20|Drug Regimen Optimization|01/31/2011|11/01/2020 60505397206|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60505397206|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011| 60505397206|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60505397306|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60505397306|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60505397306|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011| 60505437703|CE:DRO-PRX12.5|Drug Regimen Optimization|01/31/2011| 60505450209|CE:DUP-STN|Duplicate Therapy|02/04/2016| 60505450209|CE:DRO-ROSUV5|Drug Regimen Optimization|01/31/2011| 60505450309|CE:DRO-ROSUV10|Drug Regimen Optimization|01/31/2011| 60505450309|CE:DUP-STN|Duplicate Therapy|02/04/2016| 60505450409|CE:DRO-ROSUV20|Drug Regimen Optimization|01/31/2011| 60505450409|CE:DUP-STN|Duplicate Therapy|02/04/2016| 60505451703|CE:DRO-PRX10|Drug Regimen Optimization|01/31/2011| 60505451803|CE:DRO-PRX20|Drug Regimen Optimization|01/31/2011| 60505458203|CE:DUP-ARB|Duplicate Therapy|02/05/2013|04/02/2021 60505458303|CE:DUP-ARB|Duplicate Therapy|02/05/2013|04/02/2021 60505458503|CE:DUP-ARB|Duplicate Therapy|02/05/2013|06/10/2021 60505465203|CE:DUP-ARB|Duplicate Therapy|02/05/2013|10/30/2021 60505465303|CE:DUP-ARB|Duplicate Therapy|02/05/2013|10/30/2021 60505465303|CE:DRO-OLMES20|Drug Regimen Optimization|01/31/2011|10/30/2021 60505465309|CE:DRO-OLMES20|Drug Regimen Optimization|01/31/2011|10/30/2021 60505465309|CE:DUP-ARB|Duplicate Therapy|02/05/2013|10/30/2021 60505465403|CE:DUP-ARB|Duplicate Therapy|02/05/2013|10/30/2021 60505465409|CE:DUP-ARB|Duplicate Therapy|02/05/2013|10/30/2021 60505470203|CE:DRO-SOLAF5|Drug Regimen Optimization|01/31/2011| 60505470209|CE:DRO-SOLAF5|Drug Regimen Optimization|01/31/2011| 60505471303|CE:DRO-CARVCR10|Drug Regimen Optimization|01/31/2011| 60505471403|CE:DRO-CARVCR20|Drug Regimen Optimization|01/31/2011| 60505471503|CE:DRO-CARVCR40|Drug Regimen Optimization|01/31/2011| 60505700600|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 60505700600|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60505700600|CE:DUR-DURAG|Duragesic (Fentanyl Transdermal)|01/31/2011| 60505700600|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60505700600|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 60505700602|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 60505700602|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60505700602|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 60505700602|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60505700602|CE:DUR-DURAG|Duragesic (Fentanyl Transdermal)|01/31/2011| 60505700700|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 60505700700|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 60505700700|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60505700700|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60505700700|CE:DUR-DURAG|Duragesic (Fentanyl Transdermal)|01/31/2011| 60505700702|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 60505700702|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60505700702|CE:DUR-DURAG|Duragesic (Fentanyl Transdermal)|01/31/2011| 60505700702|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60505700702|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 60505700800|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 60505700800|CE:DUR-DURAG|Duragesic (Fentanyl Transdermal)|01/31/2011| 60505700800|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60505700800|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 60505700800|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60505700802|CE:DUR-DURAG|Duragesic (Fentanyl Transdermal)|01/31/2011| 60505700802|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60505700802|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 60505700802|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 60505700802|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60505700900|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 60505700900|CE:DUR-DURAG|Duragesic (Fentanyl Transdermal)|01/31/2011| 60505700900|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60505700900|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60505700900|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 60505700902|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 60505700902|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60505700902|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60505700902|CE:DUR-DURAG|Duragesic (Fentanyl Transdermal)|01/31/2011| 60505700902|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 60505701002|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60505701002|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 60505701002|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60505701002|CE:DUR-DURAG|Duragesic (Fentanyl Transdermal)|01/31/2011| 60505701002|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 60505708102|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60505708102|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 60505708102|CE:DUR-DURAG|Duragesic (Fentanyl Transdermal)|01/31/2011| 60505708102|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60505708102|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 60505708202|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60505708202|CE:DUR-DURAG|Duragesic (Fentanyl Transdermal)|01/31/2011| 60505708202|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 60505708202|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 60505708202|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60505708302|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 60505708302|CE:DUR-DURAG|Duragesic (Fentanyl Transdermal)|01/31/2011| 60505708302|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60505708302|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 60505708302|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60505708402|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60505708402|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 60505708402|CE:DUR-DURAG|Duragesic (Fentanyl Transdermal)|01/31/2011| 60505708402|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60505708402|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 60574411301|CE:SYN-SYN14R|Palivizumab (Synagis)|01/31/2011| 60574411301|CE:SYN-SYN14N|Palivizumab (Synagis)|01/31/2011| 60574411301|CE:SYN-SYNAGIS|Palivizumab (Synagis)|01/31/2011| 60574411401|CE:SYN-SYN14R|Palivizumab (Synagis)|01/31/2011| 60574411401|CE:SYN-SYN14N|Palivizumab (Synagis)|01/31/2011| 60574411401|CE:SYN-SYNAGIS|Palivizumab (Synagis)|01/31/2011| 60631004030|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 60631008030|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 60631041230|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 60631041230|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 60687048111|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60687048111|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60687048111|CE:STX-STX|Subutex (buprenorphine)|12/05/2014| 60687048121|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60687048121|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60687048121|CE:STX-STX|Subutex (buprenorphine)|12/05/2014| 60687049211|CE:STX-STX|Subutex (buprenorphine)|12/05/2014| 60687049211|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60687049211|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60687049221|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60687049221|CE:STX-STX|Subutex (buprenorphine)|12/05/2014| 60687049221|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60793013601|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60793013601|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60793041130|CE:DUP-NSD|Duplicate Therapy|02/05/2013|05/13/2021 60951060270|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 60951060270|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60951060270|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 60951060270|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60951060285|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60951060285|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 60951060285|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60951060285|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 60951070070|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60951070070|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 60951070070|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 60951070070|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60951071270|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 60951071270|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 60951071270|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 60951071270|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 61442010201|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 61442010210|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 61442010260|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 61442010301|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 61442010305|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 61442010310|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 61442010360|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 61442012601|CE:DRO-MELOX7.5|Drug Regimen Optimization|01/31/2011| 61442012601|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 61442012601|CE:COX-MOBIC|COX-2 Inhibitors|01/31/2011| 61442012610|CE:DRO-MELOX7.5|Drug Regimen Optimization|01/31/2011| 61442012610|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 61442012610|CE:COX-MOBIC|COX-2 Inhibitors|01/31/2011| 61442012701|CE:COX-MOBIC|COX-2 Inhibitors|01/31/2011| 61442012701|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 61442012710|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 61442012710|CE:COX-MOBIC|COX-2 Inhibitors|01/31/2011| 61442014101|CE:DUP-STN|Duplicate Therapy|02/04/2016| 61442014101|CE:DRO-LOVA10|Drug Regimen Optimization|01/31/2011| 61442014110|CE:DUP-STN|Duplicate Therapy|02/04/2016| 61442014110|CE:DRO-LOVA10|Drug Regimen Optimization|01/31/2011| 61442014201|CE:DRO-LOVA20|Drug Regimen Optimization|01/31/2011| 61442014201|CE:DUP-STN|Duplicate Therapy|02/04/2016| 61442014210|CE:DRO-LOVA20|Drug Regimen Optimization|01/31/2011| 61442014210|CE:DUP-STN|Duplicate Therapy|02/04/2016| 61442014301|CE:DUP-STN|Duplicate Therapy|02/04/2016| 61442014310|CE:DUP-STN|Duplicate Therapy|02/04/2016| 61442045101|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 61442045101|CE:CCA-LDCARIS|Carisoprodol Containing Agents|01/31/2011| 61442045101|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 61570007201|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 61570007301|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 61570007401|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 61570011001|CE:DRO-RAMI1.25|Drug Regimen Optimization|01/31/2011| 61570011101|CE:DRO-RAMI2.50|Drug Regimen Optimization|01/31/2011| 61570011201|CE:DRO-RAMI5.00|Drug Regimen Optimization|01/31/2011| 61874007560|CE:GIM-VIB|GI Motility|02/06/2018| 61874010060|CE:GIM-VIB|GI Motility|02/06/2018| 61874011520|CE:APY-SGA|Antipsychotics|04/10/2016| 61874011530|CE:APY-SGA|Antipsychotics|04/10/2016| 61874013020|CE:APY-SGA|Antipsychotics|04/10/2016| 61874013030|CE:APY-SGA|Antipsychotics|04/10/2016| 61874014530|CE:APY-SGA|Antipsychotics|04/10/2016| 61874016030|CE:APY-SGA|Antipsychotics|04/10/2016| 61874017008|CE:APY-SGA|Antipsychotics|04/10/2016| 61958100301|CE:RAN-RAN|Ranolazine|05/25/2012| 61958100401|CE:RAN-RAN|Ranolazine|05/25/2012| 61958150101|CE:HCA-HEPC|Hepatitis C Agents Clinical|01/23/2015| 61958150101|CE:HCT-HEPC|Hepatitis C Treatment|01/31/2011| 61958180101|CE:HCA-HEPC|Hepatitis C Agents Clinical|01/23/2015| 61958220101|CE:HCA-HEPC|Hepatitis C Agents Clinical|01/23/2015| 61958240101|CE:HCA-HEPC|Hepatitis C Agents Clinical|01/23/2015| 62037072501|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 62037072501|CE:DRO-MPHER18|Drug Regimen Optimization|01/31/2011| 62037072601|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 62037072701|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 62037073401|CE:DRO-MPHER27|Drug Regimen Optimization|01/31/2011| 62037073401|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 62037082501|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 62037082675|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 62135019122|CE:FOS-FOSRENOL|Fosrenol (Lanthanum Carbonate)|01/31/2011| 62135019222|CE:FOS-FOSRENOL|Fosrenol (Lanthanum Carbonate)|01/31/2011| 62135027101|CE:DRO-RAMI1.25|Drug Regimen Optimization|01/31/2011| 62135027130|CE:DRO-RAMI1.25|Drug Regimen Optimization|01/31/2011| 62135027201|CE:DRO-RAMI2.50|Drug Regimen Optimization|01/31/2011| 62135027205|CE:DRO-RAMI2.50|Drug Regimen Optimization|01/31/2011| 62135027301|CE:DRO-RAMI5.00|Drug Regimen Optimization|01/31/2011| 62135027305|CE:DRO-RAMI5.00|Drug Regimen Optimization|01/31/2011| 62175011432|CE:DRO-OMP10|Drug Regimen Optimization|01/31/2011| 62175011437|CE:DRO-OMP10|Drug Regimen Optimization|01/31/2011| 62175011832|CE:DRO-OMP20|Drug Regimen Optimization|01/31/2011| 62175011837|CE:DRO-OMP20|Drug Regimen Optimization|01/31/2011| 62175011843|CE:DRO-OMP20|Drug Regimen Optimization|01/31/2011| 62175018046|CE:DRO-PNZ20|Drug Regimen Optimization|01/31/2011|09/01/2021 62175020432|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 62175020443|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 62175020446|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 62175020532|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 62175020543|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 62175020546|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 62175021032|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 62175021043|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 62175021046|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 62175026037|CE:DRO-NFP30|Drug Regimen Optimization|01/31/2011| 62175026043|CE:DRO-NFP30|Drug Regimen Optimization|01/31/2011| 62175026055|CE:DRO-NFP30|Drug Regimen Optimization|01/31/2011| 62175027037|CE:DRO-OXYBU5|Drug Regimen Optimization|01/31/2011| 62175027041|CE:DRO-OXYBU5|Drug Regimen Optimization|01/31/2011| 62175031037|CE:DRO-MPHER18|Drug Regimen Optimization|01/31/2011| 62175031037|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 62175031137|CE:DRO-MPHER27|Drug Regimen Optimization|01/31/2011| 62175031137|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 62175031237|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 62175031337|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 62175032046|CE:DRO-NIASA500|Drug Regimen Optimization|01/31/2011| 62175045232|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62175045232|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62175045232|CE:SUB-SUBOX|Suboxone|04/23/2013| 62175045832|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62175045832|CE:SUB-SUBOX|Suboxone|04/23/2013| 62175045832|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62175048537|CE:DRO-VPM100|Drug Regimen Optimization|01/31/2011| 62175057037|CE:DRO-VPM100|Drug Regimen Optimization|01/31/2011| 62175082032|CE:DRO-EMP20|Drug Regimen Optimization|01/31/2011| 62175082043|CE:DRO-EMP20|Drug Regimen Optimization|01/31/2011| 62175082046|CE:DRO-EMP20|Drug Regimen Optimization|01/31/2011| 62175089043|CE:DUP-STN|Duplicate Therapy|02/04/2016| 62175089043|CE:DRO-ATORV10|Drug Regimen Optimization|01/31/2011| 62175089046|CE:DRO-ATORV10|Drug Regimen Optimization|01/31/2011| 62175089046|CE:DUP-STN|Duplicate Therapy|02/04/2016| 62175089143|CE:DUP-STN|Duplicate Therapy|02/04/2016| 62175089143|CE:DRO-ATORV20|Drug Regimen Optimization|01/31/2011| 62175089146|CE:DUP-STN|Duplicate Therapy|02/04/2016| 62175089146|CE:DRO-ATORV20|Drug Regimen Optimization|01/31/2011| 62175089241|CE:DUP-STN|Duplicate Therapy|02/04/2016| 62175089241|CE:DRO-ATORV40|Drug Regimen Optimization|01/31/2011| 62175089246|CE:DUP-STN|Duplicate Therapy|02/04/2016| 62175089246|CE:DRO-ATORV40|Drug Regimen Optimization|01/31/2011| 62175089741|CE:DUP-STN|Duplicate Therapy|02/04/2016| 62175089746|CE:DUP-STN|Duplicate Therapy|02/04/2016| 62332000931|CE:DRO-VENL37.5|Drug Regimen Optimization|01/31/2011| 62332001931|CE:ASH-CMOXAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 62332001931|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62332002031|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62332002031|CE:ASH-CMOXAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 62332002730|CE:DRO-LORSA25|Drug Regimen Optimization|01/31/2011| 62332002730|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332002790|CE:DRO-LORSA25|Drug Regimen Optimization|01/31/2011| 62332002790|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332002791|CE:DRO-LORSA25|Drug Regimen Optimization|01/31/2011| 62332002791|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332002830|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332002830|CE:DRO-LORSA50|Drug Regimen Optimization|01/31/2011| 62332002890|CE:DRO-LORSA50|Drug Regimen Optimization|01/31/2011| 62332002890|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332002891|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332002891|CE:DRO-LORSA50|Drug Regimen Optimization|01/31/2011| 62332002930|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332002990|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332002991|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332004130|CE:DRO-IRBE75|Drug Regimen Optimization|01/31/2011| 62332004130|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332004190|CE:DRO-IRBE75|Drug Regimen Optimization|01/31/2011| 62332004190|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332004230|CE:DRO-IRBE150|Drug Regimen Optimization|01/31/2011| 62332004230|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332004271|CE:DRO-IRBE150|Drug Regimen Optimization|01/31/2011| 62332004271|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332004290|CE:DRO-IRBE150|Drug Regimen Optimization|01/31/2011| 62332004290|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332004330|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332004371|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332004390|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332004430|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332004490|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332004571|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332004571|CE:DRO-VALSA80|Drug Regimen Optimization|01/31/2011| 62332004590|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332004590|CE:DRO-VALSA80|Drug Regimen Optimization|01/31/2011| 62332004671|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332004671|CE:DRO-VALSA160|Drug Regimen Optimization|01/31/2011| 62332004690|CE:DRO-VALSA160|Drug Regimen Optimization|01/31/2011| 62332004690|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332004771|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332004790|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332004830|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 62332004830|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332004830|CE:DRO-LORS12.5|Drug Regimen Optimization|01/31/2011| 62332004890|CE:DRO-LORS12.5|Drug Regimen Optimization|01/31/2011| 62332004890|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 62332004890|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332004891|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 62332004891|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332004891|CE:DRO-LORS12.5|Drug Regimen Optimization|01/31/2011| 62332004930|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 62332004930|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332004990|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 62332004990|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332004991|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 62332004991|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332005030|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 62332005030|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332005090|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332005090|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 62332005091|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 62332005091|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332005130|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 62332005130|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332005190|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332005190|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 62332005230|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332005230|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 62332005290|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332005290|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 62332006030|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332006090|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332007971|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 62332007971|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332007990|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332007990|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 62332008071|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332008071|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 62332008090|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 62332008090|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332008171|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332008171|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 62332008190|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 62332008190|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332008271|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332008271|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 62332008290|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 62332008290|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332008371|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 62332008371|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332008390|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 62332008390|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332008730|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332008730|CE:DRO-TELMI20|Drug Regimen Optimization|01/31/2011| 62332008830|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332008830|CE:DRO-TELMI40|Drug Regimen Optimization|01/31/2011| 62332008930|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332009230|CE:DRO-DONEZ5|Drug Regimen Optimization|01/31/2011| 62332009290|CE:DRO-DONEZ5|Drug Regimen Optimization|01/31/2011| 62332009291|CE:DRO-DONEZ5|Drug Regimen Optimization|01/31/2011| 62332009730|CE:APY-ARI|Antipsychotics|04/10/2016| 62332009731|CE:APY-ARI|Antipsychotics|04/10/2016| 62332009830|CE:APY-ARI|Antipsychotics|04/10/2016| 62332009830|CE:DRO-ARIPI5|Drug Regimen Optimization|01/31/2011| 62332009831|CE:APY-ARI|Antipsychotics|04/10/2016| 62332009831|CE:DRO-ARIPI5|Drug Regimen Optimization|01/31/2011| 62332009930|CE:APY-ARI|Antipsychotics|04/10/2016| 62332009930|CE:DRO-ARIPI10|Drug Regimen Optimization|01/31/2011| 62332009931|CE:DRO-ARIPI10|Drug Regimen Optimization|01/31/2011| 62332009931|CE:APY-ARI|Antipsychotics|04/10/2016| 62332010030|CE:DRO-ARIPI15|Drug Regimen Optimization|01/31/2011| 62332010030|CE:APY-ARI|Antipsychotics|04/10/2016| 62332010031|CE:DRO-ARIPI15|Drug Regimen Optimization|01/31/2011| 62332010031|CE:APY-ARI|Antipsychotics|04/10/2016| 62332010130|CE:APY-ARI|Antipsychotics|04/10/2016| 62332010131|CE:APY-ARI|Antipsychotics|04/10/2016| 62332010230|CE:APY-ARI|Antipsychotics|04/10/2016| 62332010231|CE:APY-ARI|Antipsychotics|04/10/2016| 62332010330|CE:APY-ARI|Antipsychotics|04/10/2016| 62332010430|CE:APY-ARI|Antipsychotics|04/10/2016| 62332011531|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 62332011631|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 62332013130|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332013230|CE:DRO-OLMES20|Drug Regimen Optimization|01/31/2011| 62332013230|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332013290|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332013290|CE:DRO-OLMES20|Drug Regimen Optimization|01/31/2011| 62332013330|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332013390|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332014060|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 62332014060|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 62332014131|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 62332014131|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 62332014171|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 62332014171|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 62332014231|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 62332014231|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 62332014271|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 62332014271|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 62332014291|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 62332014291|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 62332014360|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 62332014360|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 62332014930|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332014930|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 62332014990|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332014990|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 62332015030|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332015030|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 62332015090|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 62332015090|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332015130|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 62332015130|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332015190|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 62332015190|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332019230|CE:DRO-SOLAF5|Drug Regimen Optimization|01/31/2011| 62332019290|CE:DRO-SOLAF5|Drug Regimen Optimization|01/31/2011| 62332020530|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332020590|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332020630|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332020690|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332020730|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332020790|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332020830|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332020890|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332020930|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 62332020930|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332021030|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332021030|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 62332021130|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332021130|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 62332021230|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332021330|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332021430|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332021530|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332034130|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332034130|CE:DRO-CARD4|Drug Regimen Optimization|01/31/2011| 62332034190|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332034190|CE:DRO-CARD4|Drug Regimen Optimization|01/31/2011| 62332034230|CE:DRO-CARD8|Drug Regimen Optimization|01/31/2011| 62332034230|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332034290|CE:DRO-CARD8|Drug Regimen Optimization|01/31/2011| 62332034290|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332034330|CE:DRO-CARD16|Drug Regimen Optimization|01/31/2011| 62332034330|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332034390|CE:DRO-CARD16|Drug Regimen Optimization|01/31/2011| 62332034390|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62332036406|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62332036406|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62332036406|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 62332036406|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62332036506|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 62332036506|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62332036506|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62332036506|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62332036606|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62332036606|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 62332036606|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62332036606|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62332036706|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62332036706|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 62332036706|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62332036706|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62332036806|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 62332036806|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62332036806|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62332036806|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62332037931|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 62332037931|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62332037931|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62332037931|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62332038031|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62332038031|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 62332038031|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62332038031|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62332038071|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 62332038071|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62332038071|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62332038071|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62332038130|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62332038130|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62332038130|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62332038130|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 62332038231|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62332038231|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 62332038231|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62332038231|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62332038271|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62332038271|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62332038271|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 62332038271|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62332038530|CE:MOD-MOD|Modafinil (Provigil)|11/06/2012| 62332038530|CE:MOD-MOD|Modafinil (Provigil)|11/08/2012| 62332038590|CE:MOD-MOD|Modafinil (Provigil)|11/08/2012| 62332038590|CE:MOD-MOD|Modafinil (Provigil)|11/06/2012| 62332038630|CE:MOD-MOD|Modafinil (Provigil)|11/08/2012| 62332038630|CE:MOD-MOD|Modafinil (Provigil)|11/06/2012| 62332038690|CE:MOD-MOD|Modafinil (Provigil)|11/08/2012| 62332038690|CE:MOD-MOD|Modafinil (Provigil)|11/06/2012| 62332042631|CE:CCC-CCCC|Cough and Cold Agents - Clinical|12/15/2015| 62332042671|CE:CCC-CCCC|Cough and Cold Agents - Clinical|12/15/2015| 62332042731|CE:CCC-CCCC|Cough and Cold Agents - Clinical|12/15/2015| 62332042771|CE:CCC-CCCC|Cough and Cold Agents - Clinical|12/15/2015| 62542030104|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 62542030104|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 62542030104|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62542030104|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 62542030104|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62542030117|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 62542030117|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62542030117|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 62542030117|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62542030117|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 62559011107|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 62559011107|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 62559011111|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 62559011111|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 62559013807|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 62559013807|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 62559015116|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 62559015116|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 62559015116|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62559015116|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62559016701|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 62559016701|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62559016701|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62559016701|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 62559017001|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 62559017001|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62559017001|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 62559017001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62559017005|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62559017005|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62559017005|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 62559017005|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 62559017101|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 62559017101|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62559017101|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62559017101|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 62559017105|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 62559017105|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 62559017105|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62559017105|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62559025001|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 62559025101|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 62559041012|CE:LVZ-LOVAZ|Lovaza|07/16/2012| 62559064030|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62559064030|CE:DRO-CARD4|Drug Regimen Optimization|01/31/2011| 62559064130|CE:DRO-CARD8|Drug Regimen Optimization|01/31/2011| 62559064130|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62559064230|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62559064230|CE:DRO-CARD16|Drug Regimen Optimization|01/31/2011| 62559064290|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62559064290|CE:DRO-CARD16|Drug Regimen Optimization|01/31/2011| 62559064330|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62559064390|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62559065090|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62559065090|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 62559065190|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62559065190|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 62559065290|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 62559065290|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62559066090|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 62559066090|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62559066190|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62559066190|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 62559066290|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 62559066290|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 62559070030|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 62559070090|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 62559070130|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 62559070190|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 62559070230|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 62559070290|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 62559070330|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 62559070390|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 62559079001|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014|12/31/2021 62559079001|CE:DRO-MPHER18|Drug Regimen Optimization|01/31/2011|12/31/2021 62559079101|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014|12/31/2021 62559079101|CE:DRO-MPHER27|Drug Regimen Optimization|01/31/2011|12/31/2021 62756013702|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 62756020201|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 62756020203|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 62756020401|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 62756020403|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 62756036888|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 62756036988|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 62756037088|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 62756044018|CE:DRO-DONEZ5|Drug Regimen Optimization|01/31/2011| 62756044081|CE:DRO-DONEZ5|Drug Regimen Optimization|01/31/2011| 62756044083|CE:DRO-DONEZ5|Drug Regimen Optimization|01/31/2011| 62756044602|CE:CCA-LDCARIS|Carisoprodol Containing Agents|01/31/2011| 62756044602|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62756044602|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62756044604|CE:CCA-LDCARIS|Carisoprodol Containing Agents|01/31/2011| 62756044604|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62756044604|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62756044605|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62756044605|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62756044605|CE:CCA-LDCARIS|Carisoprodol Containing Agents|01/31/2011| 62756045983|CE:STX-STX|Subutex (buprenorphine)|12/05/2014| 62756045983|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62756045983|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62756046083|CE:STX-STX|Subutex (buprenorphine)|12/05/2014| 62756046083|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62756046083|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62756055118|CE:DRO-OLANZ2.5|Drug Regimen Optimization|01/31/2011| 62756055118|CE:APY-SGA|Antipsychotics|04/10/2016| 62756055183|CE:DRO-OLANZ2.5|Drug Regimen Optimization|01/31/2011| 62756055183|CE:APY-SGA|Antipsychotics|04/10/2016| 62756055188|CE:APY-SGA|Antipsychotics|04/10/2016| 62756055188|CE:DRO-OLANZ2.5|Drug Regimen Optimization|01/31/2011| 62756055218|CE:APY-SGA|Antipsychotics|04/10/2016| 62756055218|CE:DRO-OLANZ5|Drug Regimen Optimization|01/31/2011| 62756055283|CE:APY-SGA|Antipsychotics|04/10/2016| 62756055283|CE:DRO-OLANZ5|Drug Regimen Optimization|01/31/2011| 62756055288|CE:APY-SGA|Antipsychotics|04/10/2016| 62756055288|CE:DRO-OLANZ5|Drug Regimen Optimization|01/31/2011| 62756055318|CE:DRO-OLANZ7.5|Drug Regimen Optimization|01/31/2011| 62756055318|CE:APY-SGA|Antipsychotics|04/10/2016| 62756055383|CE:DRO-OLANZ7.5|Drug Regimen Optimization|01/31/2011| 62756055383|CE:APY-SGA|Antipsychotics|04/10/2016| 62756055388|CE:DRO-OLANZ7.5|Drug Regimen Optimization|01/31/2011| 62756055388|CE:APY-SGA|Antipsychotics|04/10/2016| 62756055418|CE:APY-SGA|Antipsychotics|04/10/2016| 62756055418|CE:DRO-OLANZ10|Drug Regimen Optimization|01/31/2011| 62756055483|CE:APY-SGA|Antipsychotics|04/10/2016| 62756055483|CE:DRO-OLANZ10|Drug Regimen Optimization|01/31/2011| 62756055488|CE:DRO-OLANZ10|Drug Regimen Optimization|01/31/2011| 62756055488|CE:APY-SGA|Antipsychotics|04/10/2016| 62756055518|CE:APY-SGA|Antipsychotics|04/10/2016| 62756055583|CE:APY-SGA|Antipsychotics|04/10/2016| 62756055588|CE:APY-SGA|Antipsychotics|04/10/2016| 62756055618|CE:APY-SGA|Antipsychotics|04/10/2016| 62756055683|CE:APY-SGA|Antipsychotics|04/10/2016| 62756055688|CE:APY-SGA|Antipsychotics|04/10/2016| 62756075164|CE:DRO-OLAODT5|Drug Regimen Optimization|01/31/2011| 62756075164|CE:APY-SGA|Antipsychotics|04/10/2016| 62756075464|CE:DRO-OLAODT10|Drug Regimen Optimization|01/31/2011| 62756075464|CE:APY-SGA|Antipsychotics|04/10/2016| 62756075564|CE:APY-SGA|Antipsychotics|04/10/2016| 62756075764|CE:APY-SGA|Antipsychotics|04/10/2016| 62756096983|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62756096983|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62756096983|CE:SUB-SUBOX|Suboxone|04/23/2013| 62756097083|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62756097083|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 62756097083|CE:SUB-SUBOX|Suboxone|04/23/2013| 62856024530|CE:DRO-DONEZ5|Drug Regimen Optimization|01/31/2011| 63004871001|CE:HPA-HPA|HP Acthar|03/08/2016| 63090010030|CE:SDF-REVATIO|Sildenafil (Revatio)|01/31/2011| 63304045001|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 63304045001|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63304045001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63304045001|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 63304045101|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63304045101|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63304045101|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 63304045101|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 63304045201|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63304045201|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 63304045201|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 63304045201|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63304045301|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63304045301|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 63304045301|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 63304045301|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63304068301|CE:OXC-LD OXY|Oxycontin (Narcotic Analgesic)|01/31/2011| 63304068301|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 63304068301|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63304068301|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 63304068301|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63304068401|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63304068401|CE:OXC-HD OXY|Oxycontin (Narcotic Analgesic)|01/31/2011| 63304068401|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63304068401|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 63304068401|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 63304075801|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63304075801|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63304075801|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 63304075801|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 63402019030|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 63402019103|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 63402019303|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 63402019310|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011|11/23/2020 63402030230|CE:APY-SGA|Antipsychotics|04/10/2016| 63402030401|CE:APY-SGA|Antipsychotics|04/10/2016| 63402030410|CE:APY-SGA|Antipsychotics|04/10/2016| 63402030430|CE:APY-SGA|Antipsychotics|04/10/2016| 63402030630|CE:APY-SGA|Antipsychotics|04/10/2016| 63402030801|CE:APY-SGA|Antipsychotics|04/10/2016| 63402030810|CE:APY-SGA|Antipsychotics|04/10/2016| 63402030830|CE:APY-SGA|Antipsychotics|04/10/2016| 63402031230|CE:APY-SGA|Antipsychotics|04/10/2016| 63402051001|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 63402067530|CE:DUP-LABA|Duplicate Therapy|02/04/2016| 63402068106|CE:DUP-LABAC|Duplicate Therapy|02/04/2016| 63402068160|CE:DUP-LABAC|Duplicate Therapy|02/04/2016| 63402091130|CE:DUP-LABA|Duplicate Therapy|02/04/2016| 63402091164|CE:DUP-LABA|Duplicate Therapy|02/04/2016| 63459010130|CE:MOD-MOD|Modafinil (Provigil)|11/06/2012| 63459010130|CE:MOD-MOD|Modafinil (Provigil)|11/08/2012| 63459020130|CE:MOD-MOD|Modafinil (Provigil)|11/06/2012| 63459020130|CE:MOD-MOD|Modafinil (Provigil)|11/08/2012| 63459020530|CE:MOD-ARM|Modafinil (Provigil)|02/06/2018| 63459021530|CE:MOD-ARM|Modafinil (Provigil)|02/06/2018| 63459022030|CE:MOD-ARM|Modafinil (Provigil)|02/06/2018| 63459022530|CE:MOD-ARM|Modafinil (Provigil)|02/06/2018| 63459050230|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 63459050230|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63459050230|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63459050230|CE:ACT-ACTIQ200|Actiq Lozenges|01/31/2011| 63459050230|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 63459050430|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 63459050430|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 63459050430|CE:ACT-ACTIQ|Actiq Lozenges|01/31/2011| 63459050430|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63459050430|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63459050630|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 63459050630|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 63459050630|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63459050630|CE:ACT-ACTIQ|Actiq Lozenges|01/31/2011| 63459050630|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63459050830|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63459050830|CE:ACT-ACTIQ|Actiq Lozenges|01/31/2011| 63459050830|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63459050830|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 63459050830|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 63459051230|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63459051230|CE:ACT-ACTIQ|Actiq Lozenges|01/31/2011| 63459051230|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 63459051230|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63459051230|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 63459051630|CE:ACT-ACTIQ|Actiq Lozenges|01/31/2011| 63459051630|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 63459051630|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 63459051630|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63459051630|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63459054128|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63459054128|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 63459054128|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63459054128|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 63459054128|CE:FEN-FENT100|Fentora|09/24/2017| 63459054228|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63459054228|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 63459054228|CE:FEN-FENT200|Fentora|09/24/2017| 63459054228|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 63459054228|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63459054428|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63459054428|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 63459054428|CE:FEN-FENT400|Fentora|09/24/2017| 63459054428|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 63459054428|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63459054628|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63459054628|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 63459054628|CE:FEN-FENT6&8|Fentora|09/24/2017| 63459054628|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63459054628|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 63459054828|CE:FEN-FENT6&8|Fentora|09/24/2017| 63459054828|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 63459054828|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63459054828|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 63459054828|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63459070060|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63459070060|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011| 63459070060|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63459070160|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63459070160|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011| 63459070160|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63481062370|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 63481062370|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 63481062370|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63481062370|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63481062385|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63481062385|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 63481062385|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 63481062385|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63481062770|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63481062770|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 63481062770|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63481062770|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 63481062870|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 63481062870|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 63481062870|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63481062870|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63481062970|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 63481062970|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63481062970|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 63481062970|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63481068447|CE:DUP-NSD|Duplicate Therapy|02/05/2013|04/30/2022 63739000333|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63739000333|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63739000333|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63739000333|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 63739000532|CE:APY-SGA|Antipsychotics|04/10/2016| 63739002910|CE:CCC-CCCC|Cough and Cold Agents - Clinical|12/15/2015| 63739007310|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 63739007310|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63739007310|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63739007310|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63739012510|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63739012510|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 63739012510|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63739012510|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63739012810|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 63739021310|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 63739023610|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 63739028110|CE:DUP-STN|Duplicate Therapy|02/04/2016| 63739028110|CE:DRO-LOVA20|Drug Regimen Optimization|01/31/2011| 63739035510|CE:DRO-MIRTZA15|Drug Regimen Optimization|01/31/2011|12/01/2020 63739035810|CE:DRO-OMP20|Drug Regimen Optimization|01/31/2011| 63739040310|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 63739048310|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 63739048610|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 63739050832|CE:APY-SGA|Antipsychotics|04/10/2016| 63739051810|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 63739051810|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 63739051910|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 63739051910|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 63739052610|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 63739053110|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63739053110|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63739053110|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011| 63739054833|CE:DRO-OXYBU5|Drug Regimen Optimization|01/31/2011| 63739056010|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 63739057010|CE:DUP-STN|Duplicate Therapy|02/04/2016| 63739057010|CE:DRO-SIMVA5|Drug Regimen Optimization|01/31/2011| 63739057110|CE:DUP-STN|Duplicate Therapy|02/04/2016| 63739057110|CE:DRO-SIMVA10|Drug Regimen Optimization|01/31/2011| 63739057210|CE:DRO-SIMVA20|Drug Regimen Optimization|01/31/2011| 63739057210|CE:DUP-STN|Duplicate Therapy|02/04/2016| 63739057310|CE:DRO-SIMVA40|Drug Regimen Optimization|01/31/2011| 63739057310|CE:DUP-STN|Duplicate Therapy|02/04/2016| 63739059110|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 63739066510|CE:APY-SGA|Antipsychotics|04/10/2016| 63739066632|CE:APY-SGA|Antipsychotics|04/10/2016| 63739067201|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 63739067210|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 63739067310|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 63739067310|CE:DRO-LORSA25|Drug Regimen Optimization|01/31/2011| 63739067710|CE:APY-SGA|Antipsychotics|04/10/2016| 63739068401|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 63739068410|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 63739068610|CE:DRO-LORSA50|Drug Regimen Optimization|01/31/2011| 63739068610|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 63739069101|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 63739069110|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 63739069810|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 63739070110|CE:COX-MOBIC|COX-2 Inhibitors|01/31/2011| 63739070110|CE:DRO-MELOX7.5|Drug Regimen Optimization|01/31/2011| 63739070110|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 63739087710|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63739087710|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63739087710|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 63739087710|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 63739088810|CE:DRO-PRX10|Drug Regimen Optimization|01/31/2011| 63739096310|CE:DRO-PRX20|Drug Regimen Optimization|01/31/2011| 63739098410|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 63739098832|CE:APY-SGA|Antipsychotics|04/10/2016| 63824000832|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 63824000832|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 63824000834|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 63824000834|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 63824000850|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 63824000850|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 63824001966|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 63824001966|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 63824001966|CE:DXO-DEXN|Dextromethorphan Overutilization|07/16/2012| 63824001966|CE:DXO-DEXQCHLD|Dextromethorphan Overutilization|07/16/2012| 63824002335|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 63824002335|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 63824002336|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 63824002336|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 63824002346|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 63824002346|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 63824004124|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 63824004124|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 63824005632|CE:DXO-DEXY|Dextromethorphan Overutilization|07/16/2012| 63824005632|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 63824005632|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 63824005634|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 63824005634|CE:DXO-DEXY|Dextromethorphan Overutilization|07/16/2012| 63824005634|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 63824005718|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 63824005718|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 63824005736|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 63824005736|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 63824007235|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 63824007235|CE:DXO-DEXW|Dextromethorphan Overutilization|07/16/2012| 63824007235|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 63824007236|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 63824007236|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 63824007236|CE:DXO-DEXW|Dextromethorphan Overutilization|07/16/2012| 63824007246|CE:DXO-DEXW|Dextromethorphan Overutilization|07/16/2012| 63824007246|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 63824007246|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 63824017163|CE:CCC-CCCA|Cough and Cold Agents - Clinical|12/15/2015| 63824017163|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 63824017163|CE:DXO-DEXI|Dextromethorphan Overutilization|07/16/2012| 63824017165|CE:DXO-DEXI|Dextromethorphan Overutilization|07/16/2012| 63824017165|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 63824017165|CE:CCC-CCCA|Cough and Cold Agents - Clinical|12/15/2015| 63824017365|CE:DXO-DEXI|Dextromethorphan Overutilization|07/16/2012| 63824017365|CE:CCC-CCCA|Cough and Cold Agents - Clinical|12/15/2015| 63824017365|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 63824017563|CE:DXO-DEXI|Dextromethorphan Overutilization|07/16/2012| 63824017563|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 63824017563|CE:CCC-CCCA|Cough and Cold Agents - Clinical|12/15/2015| 63824017565|CE:CCC-CCCA|Cough and Cold Agents - Clinical|12/15/2015| 63824017565|CE:DXO-DEXI|Dextromethorphan Overutilization|07/16/2012| 63824017565|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 63824017765|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 63824017765|CE:CCC-CCCA|Cough and Cold Agents - Clinical|12/15/2015| 63824017765|CE:DXO-DEXI|Dextromethorphan Overutilization|07/16/2012| 63824021366|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 63824021366|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 63824021366|CE:DXO-DEXN|Dextromethorphan Overutilization|07/16/2012| 63824021366|CE:DXO-DEXQCHLD|Dextromethorphan Overutilization|07/16/2012| 63824025412|CE:CCC-CCCA|Cough and Cold Agents - Clinical|12/15/2015| 63824025612|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 63824025612|CE:DXO-DEXDDCHD|Dextromethorphan Overutilization|07/16/2012| 63824028267|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 63824050066|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 63824060064|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 63868008701|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 63868015410|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 63868032550|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 63868046501|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 63868046550|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 63868061132|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 63868075940|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 63868082354|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 64011024702|CE:MAK-MAK|Makena|06/12/2015|05/31/2021 64011030103|CE:MAK-MAK|Makena|06/12/2015| 64376060501|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013|12/04/2020 64376061216|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013|02/13/2021 64376061240|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013|02/13/2021 64376064301|CE:OPO-OOVU|Opiate Overutilization|11/05/2013|09/16/2021 64376064301|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|09/16/2021 64376064301|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|09/16/2021 64376064301|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020|09/16/2021 64376064305|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020|09/16/2021 64376064305|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|09/16/2021 64376064305|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|09/16/2021 64376064305|CE:OPO-OOVU|Opiate Overutilization|11/05/2013|09/16/2021 64376064801|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|09/16/2021 64376064801|CE:OPO-OOVU|Opiate Overutilization|11/05/2013|09/16/2021 64376064801|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020|09/16/2021 64376064801|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|09/16/2021 64376064805|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|09/16/2021 64376064805|CE:OPO-OOVU|Opiate Overutilization|11/05/2013|09/16/2021 64376064805|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|09/16/2021 64376064805|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020|09/16/2021 64376064901|CE:OPO-OOVU|Opiate Overutilization|11/05/2013|09/16/2021 64376064901|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|09/16/2021 64376064901|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|09/16/2021 64376064901|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020|09/16/2021 64376064905|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020|09/16/2021 64376064905|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|09/16/2021 64376064905|CE:OPO-OOVU|Opiate Overutilization|11/05/2013|09/16/2021 64376064905|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|09/16/2021 64376065740|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013|10/31/2020 64376065740|CE:DXO-DEXQ|Dextromethorphan Overutilization|07/16/2012|10/31/2020 64376065740|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015|10/31/2020 64380071206|CE:CCC-CCCC|Cough and Cold Agents - Clinical|12/15/2015| 64380071207|CE:CCC-CCCC|Cough and Cold Agents - Clinical|12/15/2015| 64380071306|CE:CCC-CCCC|Cough and Cold Agents - Clinical|12/15/2015| 64380071307|CE:CCC-CCCC|Cough and Cold Agents - Clinical|12/15/2015| 64380076111|CE:LVZ-LOVAZ|Lovaza|07/16/2012| 64380079506|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 64380079508|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 64380080706|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 64380080707|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 64380080806|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 64380080807|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 64380080906|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 64380080907|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 64380084206|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 64380084306|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 64380084307|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 64380086706|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 64380086707|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 64380086806|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 64380086807|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 64380086906|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 64380086907|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 64380093504|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 64380093505|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 64380093508|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 64543004404|CE:CCC-CCCA|Cough and Cold Agents - Clinical|12/15/2015| 64543004416|CE:CCC-CCCA|Cough and Cold Agents - Clinical|12/15/2015| 64543009790|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 64543009790|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 64543009790|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 64543010504|CE:DXO-DEXO|Dextromethorphan Overutilization|07/16/2012| 64543010504|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 64543010504|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 64543010504|CE:DXO-DEXQ|Dextromethorphan Overutilization|07/16/2012| 64543010516|CE:DXO-DEXO|Dextromethorphan Overutilization|07/16/2012| 64543010516|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 64543010516|CE:DXO-DEXQ|Dextromethorphan Overutilization|07/16/2012| 64543010516|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 64597030160|CE:NUE-NUE|Nuedexta|05/02/2017| 64720013010|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 64720013210|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 64720013510|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 64720013610|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 64764008060|CE:GIM-LUB|GI Motility|01/18/2017| 64764012103|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 64764012303|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 64764012403|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 64764012530|CE:DPP-ALO12|DPP-4 Inhibitors|09/25/2018| 64764024060|CE:GIM-LUB|GI Motility|01/18/2017| 64764025030|CE:DPP-ALO25|DPP-4 Inhibitors|09/25/2018| 64764025103|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 64764025303|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 64764025403|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 64764030230|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 64764030430|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 64764033560|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 64764033760|CE:DPP-DPPC|DPP-4 Inhibitors|09/25/2018| 64764054130|CE:DRO-LPZ15|Drug Regimen Optimization|01/31/2011| 64764062530|CE:DPP-ALG6|DPP-4 Inhibitors|09/25/2018| 64764080510|CE:ASH-RAMELT|Anxiolytics Sedatives and Hypnotics|01/31/2011| 64764080530|CE:ASH-RAMELT|Anxiolytics Sedatives and Hypnotics|01/31/2011| 64896069501|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 64896069501|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 64896069501|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 64896069501|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 64896069513|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 64896069513|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 64896069513|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 64896069513|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 64896069613|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 64896069613|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 64896069613|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 64896069701|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 64896069701|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 64896069701|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 64896069701|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 64896069713|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 64896069713|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 64896069713|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 64896069713|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 64896069801|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 64896069801|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 64896069801|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 64896069801|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 64896069813|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 64896069813|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 64896069813|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 64896069813|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 64896069901|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 64896069901|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 64896069901|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 64896069901|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 64896069913|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 64896069913|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 64896069913|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 64896069913|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 64896070101|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 64896070101|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 64896070101|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 64896070101|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 64896070113|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 64896070113|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 64896070113|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 64896070113|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 64980019401|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013|09/30/2023 64980019501|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013|11/30/2022 64980019601|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013|11/30/2023 64980020612|CE:LTMC-ZIL|Leukotriene Modifiers - Clinical|12/15/2015| 64980020901|CE:DRO-OXYBU5|Drug Regimen Optimization|01/31/2011| 64980022101|CE:ADD-IRMETHYL|ADD/ADHD Agents|02/13/2014| 64980022201|CE:ADD-IRMETHYL|ADD/ADHD Agents|02/13/2014| 64980022301|CE:ADD-IRMETHYL|ADD/ADHD Agents|02/13/2014| 64980027903|CE:DRO-GLIP2.5|Drug Regimen Optimization|01/31/2011| 64980028001|CE:DRO-GLIP5|Drug Regimen Optimization|01/31/2011| 64980028005|CE:DRO-GLIP5|Drug Regimen Optimization|01/31/2011| 64980028010|CE:DRO-GLIP5|Drug Regimen Optimization|01/31/2011| 64980029001|CE:APY-FGA|Antipsychotics|04/10/2016| 64980029101|CE:APY-FGA|Antipsychotics|04/10/2016| 64980029201|CE:APY-FGA|Antipsychotics|04/10/2016| 64980029301|CE:APY-FGA|Antipsychotics|04/10/2016| 64980037303|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 64980037403|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 64980037503|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 64980037603|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 64980037703|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 64980037803|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 64980037903|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 64980045303|CE:GIM-ALO|GI Motility|01/18/2017| 64980045403|CE:GIM-ALO|GI Motility|01/18/2017| 64980047201|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 64980047201|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 64980050448|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 64980050924|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 64980050924|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 65162003310|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162003310|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162003310|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 65162003310|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 65162003311|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|03/23/2021 65162003311|CE:OPO-OOVU|Opiate Overutilization|11/05/2013|03/23/2021 65162003311|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|03/23/2021 65162003311|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020|03/23/2021 65162003416|CE:LVZ-LOVAZ|Lovaza|07/16/2012| 65162004710|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 65162004710|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 65162004710|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162004710|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162004750|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162004750|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162004750|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 65162004750|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 65162004810|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 65162004810|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 65162004810|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162004810|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162004910|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162004910|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 65162004910|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 65162004910|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162004950|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162004950|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 65162004950|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162004950|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 65162005010|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 65162005010|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 65162005010|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162005010|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162005110|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162005110|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 65162005110|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 65162005110|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162005150|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 65162005150|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162005150|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 65162005150|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162005703|CE:DUP-RXF|Duplicate Therapy|02/04/2016| 65162005710|CE:DUP-RXF|Duplicate Therapy|02/04/2016| 65162010110|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 65162010111|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 65162010150|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 65162010210|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 65162010211|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 65162010250|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 65162010310|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 65162010350|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 65162011510|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162011510|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162011510|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 65162011510|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 65162011511|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162011511|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 65162011511|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 65162011511|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162011550|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 65162011550|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162011550|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162011550|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 65162018810|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 65162018811|CE:DUP-NSD|Duplicate Therapy|02/05/2013|11/23/2020 65162018850|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 65162018910|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 65162018911|CE:DUP-NSD|Duplicate Therapy|02/05/2013|12/10/2020 65162018950|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 65162019010|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 65162019011|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 65162019050|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 65162020710|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 65162020710|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 65162020710|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162020710|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162020750|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 65162020750|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162020750|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162020750|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 65162022621|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 65162022623|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 65162023109|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 65162023109|CE:DRO-MPHER18|Drug Regimen Optimization|01/31/2011| 65162023309|CE:DRO-MPHER27|Drug Regimen Optimization|01/31/2011| 65162023309|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 65162023509|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 65162023709|CE:ADD-ERCONCER|ADD/ADHD Agents|02/13/2014| 65162024803|CE:GIM-ALO|GI Motility|01/18/2017| 65162024903|CE:GIM-ALO|GI Motility|01/18/2017| 65162028003|CE:APY-SGA|Antipsychotics|04/10/2016| 65162028103|CE:APY-SGA|Antipsychotics|04/10/2016| 65162028203|CE:APY-SGA|Antipsychotics|04/10/2016| 65162028303|CE:APY-SGA|Antipsychotics|04/10/2016| 65162032109|CE:DRO-NIASA500|Drug Regimen Optimization|01/31/2011| 65162035109|CE:SDF-REVATIO|Sildenafil (Revatio)|01/31/2011| 65162037110|CE:DRO-OXYBU5|Drug Regimen Optimization|01/31/2011| 65162037150|CE:DRO-OXYBU5|Drug Regimen Optimization|01/31/2011| 65162041503|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162041503|CE:SUB-SUBOX|Suboxone|04/23/2013| 65162041503|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162041603|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162041603|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162041603|CE:SUB-SUBOX|Suboxone|04/23/2013| 65162043606|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 65162043806|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 65162044110|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 65162044111|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 65162044150|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013|01/13/2021 65162044210|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 65162044211|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 65162046410|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 65162046450|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 65162046510|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 65162046550|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 65162046609|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 65162046610|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 65162046650|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 65162050603|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 65162050606|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 65162050609|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 65162050650|CE:DUP-NSD|Duplicate Therapy|02/05/2013|01/24/2021 65162052110|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 65162052111|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 65162052210|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 65162055310|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162055310|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162055610|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162055610|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162055610|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 65162055610|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162055650|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 65162055650|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162055650|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162055650|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162055710|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162055710|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162055710|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 65162055710|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162055750|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 65162055750|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162055750|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162055750|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162059020|CE:FOS-FOSRENOL|Fosrenol (Lanthanum Carbonate)|01/31/2011|01/13/2021 65162061710|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 65162061710|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162061710|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 65162061710|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162061711|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 65162061711|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162061711|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 65162061711|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162061750|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 65162061750|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162061750|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 65162061750|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162062710|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 65162062710|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162062710|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 65162062710|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162062711|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 65162062711|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162062711|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162062711|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 65162062750|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162062750|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162062750|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 65162062750|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 65162063609|CE:DRO-PNZ20|Drug Regimen Optimization|01/31/2011| 65162067384|CE:APY-ARI|Antipsychotics|04/10/2016| 65162067684|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 65162068086|CE:DXO-DEXN|Dextromethorphan Overutilization|07/16/2012| 65162068086|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 65162068086|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 65162068086|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 65162068086|CE:DXO-DEXO|Dextromethorphan Overutilization|07/16/2012| 65162068090|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 65162068090|CE:DXO-DEXN|Dextromethorphan Overutilization|07/16/2012| 65162068090|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 65162068090|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 65162068090|CE:DXO-DEXO|Dextromethorphan Overutilization|07/16/2012| 65162068784|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162068784|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162068784|CE:ASH-LORAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 65162068784|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65162069890|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 65162074510|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 65162075510|CE:DRO-DIVAL250|Drug Regimen Optimization|01/31/2011| 65162075550|CE:DRO-DIVAL250|Drug Regimen Optimization|01/31/2011| 65162076110|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 65162076111|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 65162076210|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 65162076211|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 65162076310|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 65162076311|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 65162076410|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 65162076411|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 65162076510|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 65162076511|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 65162076610|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 65162076611|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 65162076710|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 65162076711|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 65162076810|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 65162076811|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 65162076910|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 65162076911|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 65162077810|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 65162077810|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 65162083366|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 65162089374|CE:APY-ARI|Antipsychotics|04/10/2016| 65162089603|CE:APY-ARI|Antipsychotics|04/10/2016| 65162089609|CE:APY-ARI|Antipsychotics|04/10/2016| 65162089703|CE:APY-ARI|Antipsychotics|04/10/2016| 65162089703|CE:DRO-ARIPI5|Drug Regimen Optimization|01/31/2011| 65162089709|CE:APY-ARI|Antipsychotics|04/10/2016| 65162089709|CE:DRO-ARIPI5|Drug Regimen Optimization|01/31/2011| 65162089803|CE:DRO-ARIPI10|Drug Regimen Optimization|01/31/2011| 65162089803|CE:APY-ARI|Antipsychotics|04/10/2016| 65162089809|CE:DRO-ARIPI10|Drug Regimen Optimization|01/31/2011| 65162089809|CE:APY-ARI|Antipsychotics|04/10/2016| 65162089903|CE:APY-ARI|Antipsychotics|04/10/2016| 65162089903|CE:DRO-ARIPI15|Drug Regimen Optimization|01/31/2011| 65162089909|CE:APY-ARI|Antipsychotics|04/10/2016| 65162089909|CE:DRO-ARIPI15|Drug Regimen Optimization|01/31/2011| 65162090103|CE:APY-ARI|Antipsychotics|04/10/2016| 65162090109|CE:APY-ARI|Antipsychotics|04/10/2016| 65162090203|CE:APY-ARI|Antipsychotics|04/10/2016| 65162090209|CE:APY-ARI|Antipsychotics|04/10/2016| 65162091174|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 65162098908|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 65162099208|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 65162099308|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 65162099508|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 65162099708|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 65224085009|CE:DUP-NSD|Duplicate Therapy|02/05/2013|06/26/2021 65597010130|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65597010330|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65597010330|CE:DRO-OLMES20|Drug Regimen Optimization|01/31/2011| 65597010430|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65597010530|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65597010530|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65597010630|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65597010630|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65597010730|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65597010730|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65597011030|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65597011130|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65597011230|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65597011330|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65597011430|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65597011430|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65597011530|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65597011530|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65597011630|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65597011630|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65597011730|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65597011730|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65597011830|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65597011830|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65597020130|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 65597020230|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 65597020290|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 65597020330|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 65597020390|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 65597030110|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|05/02/2021 65597030110|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020|05/02/2021 65597030110|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|05/02/2021 65597030110|CE:OPO-OOVU|Opiate Overutilization|11/05/2013|05/02/2021 65597030210|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|04/14/2021 65597030210|CE:OPO-OOVU|Opiate Overutilization|11/05/2013|04/14/2021 65597030210|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|04/14/2021 65597030210|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020|04/14/2021 65597030310|CE:OPO-OOVU|Opiate Overutilization|11/05/2013|05/02/2021 65597030310|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|05/02/2021 65597030310|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|05/02/2021 65597030310|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020|05/02/2021 65597030410|CE:OPO-OOVU|Opiate Overutilization|11/05/2013|05/02/2021 65597030410|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|05/02/2021 65597030410|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|05/02/2021 65597030410|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020|05/02/2021 65649000330|CE:GIM-TRU|GI Motility|02/06/2018| 65649015090|CE:REL-REL|Relistor|09/24/2013| 65649030103|CE:RIF-XIF200|Rifaximin (Xifaxan)|01/31/2011| 65649030302|CE:RIF-XIF550|Rifaximin (Xifaxan)|01/31/2011| 65649031112|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65649055103|CE:REL-REL|Relistor|09/24/2013| 65649055204|CE:REL-REL|Relistor|09/24/2013| 65757040103|CE:APY-SGA|Antipsychotics|04/10/2016| 65757040203|CE:APY-SGA|Antipsychotics|04/10/2016| 65757040303|CE:APY-SGA|Antipsychotics|04/10/2016| 65757040403|CE:APY-SGA|Antipsychotics|04/10/2016| 65757050003|CE:APY-SGA|Antipsychotics|04/10/2016| 65862000501|CE:DRO-CTP10|Drug Regimen Optimization|01/31/2011| 65862000505|CE:DRO-CTP10|Drug Regimen Optimization|01/31/2011| 65862000601|CE:DRO-CTP20|Drug Regimen Optimization|01/31/2011| 65862000605|CE:DRO-CTP20|Drug Regimen Optimization|01/31/2011| 65862001101|CE:DRO-SRL25|Drug Regimen Optimization|01/31/2011| 65862001105|CE:DRO-SRL25|Drug Regimen Optimization|01/31/2011| 65862001130|CE:DRO-SRL25|Drug Regimen Optimization|01/31/2011| 65862001201|CE:DRO-SRL50|Drug Regimen Optimization|01/31/2011| 65862001205|CE:DRO-SRL50|Drug Regimen Optimization|01/31/2011| 65862001230|CE:DRO-SRL50|Drug Regimen Optimization|01/31/2011| 65862002106|CE:DRO-MIRODT15|Drug Regimen Optimization|01/31/2011| 65862003130|CE:DRO-MIRTZA15|Drug Regimen Optimization|01/31/2011| 65862005090|CE:DUP-STN|Duplicate Therapy|02/04/2016| 65862005090|CE:DRO-SIMVA5|Drug Regimen Optimization|01/31/2011| 65862005130|CE:DRO-SIMVA10|Drug Regimen Optimization|01/31/2011| 65862005130|CE:DUP-STN|Duplicate Therapy|02/04/2016| 65862005190|CE:DUP-STN|Duplicate Therapy|02/04/2016| 65862005190|CE:DRO-SIMVA10|Drug Regimen Optimization|01/31/2011| 65862005199|CE:DRO-SIMVA10|Drug Regimen Optimization|01/31/2011| 65862005199|CE:DUP-STN|Duplicate Therapy|02/04/2016| 65862005230|CE:DRO-SIMVA20|Drug Regimen Optimization|01/31/2011| 65862005230|CE:DUP-STN|Duplicate Therapy|02/04/2016| 65862005290|CE:DRO-SIMVA20|Drug Regimen Optimization|01/31/2011| 65862005290|CE:DUP-STN|Duplicate Therapy|02/04/2016| 65862005299|CE:DUP-STN|Duplicate Therapy|02/04/2016| 65862005299|CE:DRO-SIMVA20|Drug Regimen Optimization|01/31/2011| 65862005330|CE:DUP-STN|Duplicate Therapy|02/04/2016| 65862005330|CE:DRO-SIMVA40|Drug Regimen Optimization|01/31/2011| 65862005390|CE:DRO-SIMVA40|Drug Regimen Optimization|01/31/2011| 65862005390|CE:DUP-STN|Duplicate Therapy|02/04/2016| 65862005399|CE:DUP-STN|Duplicate Therapy|02/04/2016| 65862005399|CE:DRO-SIMVA40|Drug Regimen Optimization|01/31/2011| 65862005430|CE:DUP-STN|Duplicate Therapy|02/04/2016| 65862005490|CE:DUP-STN|Duplicate Therapy|02/04/2016| 65862005499|CE:DUP-STN|Duplicate Therapy|02/04/2016| 65862009701|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 65862009701|CE:COX-MOBIC|COX-2 Inhibitors|01/31/2011| 65862009701|CE:DRO-MELOX7.5|Drug Regimen Optimization|01/31/2011| 65862009705|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 65862009705|CE:DRO-MELOX7.5|Drug Regimen Optimization|01/31/2011| 65862009705|CE:COX-MOBIC|COX-2 Inhibitors|01/31/2011| 65862013399|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65862013401|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65862013499|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65862015505|CE:DRO-PRX20|Drug Regimen Optimization|01/31/2011| 65862015530|CE:DRO-PRX20|Drug Regimen Optimization|01/31/2011| 65862015599|CE:DRO-PRX20|Drug Regimen Optimization|01/31/2011| 65862015801|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862015801|CE:CCA-LDCARIS|Carisoprodol Containing Agents|01/31/2011| 65862015801|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862015901|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 65862016001|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 65862016190|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65862016290|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65862016390|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65862019105|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862019105|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011| 65862019105|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862019801|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 65862019805|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 65862019899|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 65862019901|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 65862019905|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 65862019999|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 65862020001|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 65862020005|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 65862020190|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862020190|CE:DRO-LORSA25|Drug Regimen Optimization|01/31/2011| 65862020199|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862020199|CE:DRO-LORSA25|Drug Regimen Optimization|01/31/2011| 65862020230|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862020230|CE:DRO-LORSA50|Drug Regimen Optimization|01/31/2011| 65862020290|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862020290|CE:DRO-LORSA50|Drug Regimen Optimization|01/31/2011| 65862020299|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862020299|CE:DRO-LORSA50|Drug Regimen Optimization|01/31/2011| 65862020330|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862020390|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862020399|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862021401|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 65862021501|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 65862029390|CE:DRO-ROSUV5|Drug Regimen Optimization|01/31/2011| 65862029390|CE:DUP-STN|Duplicate Therapy|02/04/2016| 65862029490|CE:DRO-ROSUV10|Drug Regimen Optimization|01/31/2011| 65862029490|CE:DUP-STN|Duplicate Therapy|02/04/2016| 65862029590|CE:DUP-STN|Duplicate Therapy|02/04/2016| 65862029590|CE:DRO-ROSUV20|Drug Regimen Optimization|01/31/2011| 65862029630|CE:DUP-STN|Duplicate Therapy|02/04/2016| 65862029690|CE:DUP-STN|Duplicate Therapy|02/04/2016| 65862030801|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65862030901|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65862037301|CE:DRO-ETP5|Drug Regimen Optimization|01/31/2011| 65862037305|CE:DRO-ETP5|Drug Regimen Optimization|01/31/2011| 65862037401|CE:DRO-ETP10|Drug Regimen Optimization|01/31/2011| 65862037405|CE:DRO-ETP10|Drug Regimen Optimization|01/31/2011| 65862045460|CE:ALP-ALP|Alprazolam|05/28/2015| 65862045460|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862045460|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862045460|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862045560|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862045560|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862045560|CE:ALP-ALP|Alprazolam|05/28/2015| 65862045560|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862045660|CE:ALP-ALP|Alprazolam|05/28/2015| 65862045660|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862045660|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862045660|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862045760|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862045760|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862045760|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862045760|CE:ALP-ALP|Alprazolam|05/28/2015| 65862046830|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862046830|CE:DRO-LORS12.5|Drug Regimen Optimization|01/31/2011| 65862046830|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65862046890|CE:DRO-LORS12.5|Drug Regimen Optimization|01/31/2011| 65862046890|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65862046890|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862046899|CE:DRO-LORS12.5|Drug Regimen Optimization|01/31/2011| 65862046899|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862046899|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65862046930|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65862046930|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862046990|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862046990|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65862046999|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862046999|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65862047030|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862047030|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65862047090|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65862047090|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862047099|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65862047099|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862047401|CE:DRO-RAMI1.25|Drug Regimen Optimization|01/31/2011| 65862047501|CE:DRO-RAMI2.50|Drug Regimen Optimization|01/31/2011| 65862047505|CE:DRO-RAMI2.50|Drug Regimen Optimization|01/31/2011| 65862047601|CE:DRO-RAMI5.00|Drug Regimen Optimization|01/31/2011| 65862047605|CE:DRO-RAMI5.00|Drug Regimen Optimization|01/31/2011| 65862048901|CE:APY-SGA|Antipsychotics|04/10/2016| 65862049001|CE:APY-SGA|Antipsychotics|04/10/2016| 65862049101|CE:APY-SGA|Antipsychotics|04/10/2016| 65862049301|CE:APY-SGA|Antipsychotics|04/10/2016| 65862049460|CE:APY-SGA|Antipsychotics|04/10/2016| 65862049501|CE:APY-SGA|Antipsychotics|04/10/2016| 65862051205|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 65862051290|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 65862051305|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 65862051330|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 65862051405|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 65862051430|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 65862051501|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 65862051601|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 65862052205|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 65862052301|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 65862052305|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 65862052401|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 65862052405|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 65862052518|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 65862052560|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 65862052618|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 65862052660|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 65862052701|CE:DRO-VENL37.5|Drug Regimen Optimization|01/31/2011| 65862052730|CE:DRO-VENL37.5|Drug Regimen Optimization|01/31/2011| 65862052790|CE:DRO-VENL37.5|Drug Regimen Optimization|01/31/2011| 65862052799|CE:DRO-VENL37.5|Drug Regimen Optimization|01/31/2011| 65862052801|CE:DRO-VENL75|Drug Regimen Optimization|01/31/2011| 65862052830|CE:DRO-VENL75|Drug Regimen Optimization|01/31/2011| 65862052890|CE:DRO-VENL75|Drug Regimen Optimization|01/31/2011| 65862052899|CE:DRO-VENL75|Drug Regimen Optimization|01/31/2011| 65862054799|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862054799|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65862054890|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862054890|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65862054899|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862054899|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65862054990|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65862054990|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862054999|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65862054999|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862055005|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65862055005|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862055090|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65862055090|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862055105|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862055105|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65862055190|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65862055190|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862055990|CE:DRO-PNZ20|Drug Regimen Optimization|01/31/2011| 65862056130|CE:APY-SGA|Antipsychotics|04/10/2016| 65862056130|CE:DRO-OLANZ2.5|Drug Regimen Optimization|01/31/2011| 65862056199|CE:DRO-OLANZ2.5|Drug Regimen Optimization|01/31/2011| 65862056199|CE:APY-SGA|Antipsychotics|04/10/2016| 65862056230|CE:APY-SGA|Antipsychotics|04/10/2016| 65862056230|CE:DRO-OLANZ5|Drug Regimen Optimization|01/31/2011| 65862056299|CE:DRO-OLANZ5|Drug Regimen Optimization|01/31/2011| 65862056299|CE:APY-SGA|Antipsychotics|04/10/2016| 65862056330|CE:APY-SGA|Antipsychotics|04/10/2016| 65862056330|CE:DRO-OLANZ7.5|Drug Regimen Optimization|01/31/2011| 65862056399|CE:APY-SGA|Antipsychotics|04/10/2016| 65862056399|CE:DRO-OLANZ7.5|Drug Regimen Optimization|01/31/2011| 65862056430|CE:DRO-OLANZ10|Drug Regimen Optimization|01/31/2011| 65862056430|CE:APY-SGA|Antipsychotics|04/10/2016| 65862056499|CE:APY-SGA|Antipsychotics|04/10/2016| 65862056499|CE:DRO-OLANZ10|Drug Regimen Optimization|01/31/2011| 65862056530|CE:APY-SGA|Antipsychotics|04/10/2016| 65862056599|CE:APY-SGA|Antipsychotics|04/10/2016| 65862056630|CE:APY-SGA|Antipsychotics|04/10/2016| 65862056699|CE:APY-SGA|Antipsychotics|04/10/2016| 65862056790|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 65862056890|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 65862057030|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862057190|CE:DRO-VALSA80|Drug Regimen Optimization|01/31/2011| 65862057190|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862057290|CE:DRO-VALSA160|Drug Regimen Optimization|01/31/2011| 65862057290|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862057390|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862057490|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 65862059401|CE:DRO-DIVAL250|Drug Regimen Optimization|01/31/2011| 65862059499|CE:DRO-DIVAL250|Drug Regimen Optimization|01/31/2011| 65862060101|CE:MOD-MOD|Modafinil (Provigil)|11/08/2012| 65862060101|CE:MOD-MOD|Modafinil (Provigil)|11/06/2012| 65862060130|CE:MOD-MOD|Modafinil (Provigil)|11/08/2012| 65862060130|CE:MOD-MOD|Modafinil (Provigil)|11/06/2012| 65862060201|CE:MOD-MOD|Modafinil (Provigil)|11/08/2012| 65862060201|CE:MOD-MOD|Modafinil (Provigil)|11/06/2012| 65862060230|CE:MOD-MOD|Modafinil (Provigil)|11/06/2012| 65862060230|CE:MOD-MOD|Modafinil (Provigil)|11/08/2012| 65862065603|CE:DRO-OLAODT5|Drug Regimen Optimization|01/31/2011| 65862065603|CE:APY-SGA|Antipsychotics|04/10/2016| 65862065703|CE:DRO-OLAODT10|Drug Regimen Optimization|01/31/2011| 65862065703|CE:APY-SGA|Antipsychotics|04/10/2016| 65862065803|CE:APY-SGA|Antipsychotics|04/10/2016| 65862065903|CE:APY-SGA|Antipsychotics|04/10/2016| 65862066105|CE:APY-ARI|Antipsychotics|04/10/2016| 65862066130|CE:APY-ARI|Antipsychotics|04/10/2016| 65862066205|CE:DRO-ARIPI5|Drug Regimen Optimization|01/31/2011| 65862066205|CE:APY-ARI|Antipsychotics|04/10/2016| 65862066230|CE:DRO-ARIPI5|Drug Regimen Optimization|01/31/2011| 65862066230|CE:APY-ARI|Antipsychotics|04/10/2016| 65862066305|CE:DRO-ARIPI10|Drug Regimen Optimization|01/31/2011| 65862066305|CE:APY-ARI|Antipsychotics|04/10/2016| 65862066330|CE:DRO-ARIPI10|Drug Regimen Optimization|01/31/2011| 65862066330|CE:APY-ARI|Antipsychotics|04/10/2016| 65862066405|CE:DRO-ARIPI15|Drug Regimen Optimization|01/31/2011| 65862066405|CE:APY-ARI|Antipsychotics|04/10/2016| 65862066430|CE:DRO-ARIPI15|Drug Regimen Optimization|01/31/2011| 65862066430|CE:APY-ARI|Antipsychotics|04/10/2016| 65862066505|CE:APY-ARI|Antipsychotics|04/10/2016| 65862066530|CE:APY-ARI|Antipsychotics|04/10/2016| 65862066605|CE:APY-ARI|Antipsychotics|04/10/2016| 65862066630|CE:APY-ARI|Antipsychotics|04/10/2016| 65862067001|CE:DUP-MGL|Duplicate Therapy|02/05/2013| 65862067101|CE:DUP-MGL|Duplicate Therapy|02/05/2013| 65862067201|CE:DUP-MGL|Duplicate Therapy|02/05/2013| 65862067601|CE:ALP-ALP|Alprazolam|05/28/2015| 65862067601|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862067601|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862067601|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862067605|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862067605|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862067605|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862067605|CE:ALP-ALP|Alprazolam|05/28/2015| 65862067699|CE:ALP-ALP|Alprazolam|05/28/2015| 65862067699|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862067699|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862067699|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862067701|CE:ALP-ALP|Alprazolam|05/28/2015| 65862067701|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862067701|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862067701|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862067705|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862067705|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862067705|CE:ALP-ALP|Alprazolam|05/28/2015| 65862067705|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862067799|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862067799|CE:ALP-ALP|Alprazolam|05/28/2015| 65862067799|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862067799|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862067801|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862067801|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862067801|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862067801|CE:ALP-ALP|Alprazolam|05/28/2015| 65862067805|CE:ALP-ALP|Alprazolam|05/28/2015| 65862067805|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862067805|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862067805|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862067899|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862067899|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862067899|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862067899|CE:ALP-ALP|Alprazolam|05/28/2015| 65862067901|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862067901|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862067901|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862067901|CE:ALP-ALP|Alprazolam|05/28/2015| 65862068890|CE:SDF-REVATIO|Sildenafil (Revatio)|01/31/2011| 65862070260|CE:APY-SGA|Antipsychotics|04/10/2016| 65862070360|CE:APY-SGA|Antipsychotics|04/10/2016| 65862070460|CE:APY-SGA|Antipsychotics|04/10/2016| 65862070560|CE:APY-SGA|Antipsychotics|04/10/2016| 65862073730|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862073830|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862073930|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862074030|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862074130|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862074230|CE:DRO-OLMES20|Drug Regimen Optimization|01/31/2011| 65862074230|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862074290|CE:DRO-OLMES20|Drug Regimen Optimization|01/31/2011| 65862074290|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862074330|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862074390|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862077930|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862077930|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65862077990|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65862077990|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862078030|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65862078030|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862078090|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862078090|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65862078130|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862078130|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65862078190|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65862078190|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862078330|CE:DRO-EMP20|Drug Regimen Optimization|01/31/2011| 65862078390|CE:DRO-EMP20|Drug Regimen Optimization|01/31/2011| 65862080530|CE:MOD-ARM|Modafinil (Provigil)|02/06/2018| 65862080630|CE:MOD-ARM|Modafinil (Provigil)|02/06/2018| 65862080730|CE:MOD-ARM|Modafinil (Provigil)|02/06/2018| 65862083430|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65862083430|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862083530|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862083530|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65862083630|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862083630|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65862083730|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65862083730|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862083830|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65862083830|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862084401|CE:APY-SGA|Antipsychotics|04/10/2016| 65862084501|CE:APY-SGA|Antipsychotics|04/10/2016| 65862084601|CE:APY-SGA|Antipsychotics|04/10/2016| 65862084605|CE:APY-SGA|Antipsychotics|04/10/2016| 65862084701|CE:APY-SGA|Antipsychotics|04/10/2016| 65862085430|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862085530|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862085630|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862085730|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862086130|CE:DRO-DARI7.5|Drug Regimen Optimization|01/31/2011| 65862086703|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862086703|CE:DRO-TELMI20|Drug Regimen Optimization|01/31/2011| 65862086803|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862086803|CE:DRO-TELMI40|Drug Regimen Optimization|01/31/2011| 65862086903|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862087360|CE:APY-SGA|Antipsychotics|04/10/2016| 65862087460|CE:APY-SGA|Antipsychotics|04/10/2016| 65862087560|CE:APY-SGA|Antipsychotics|04/10/2016| 65862087660|CE:APY-SGA|Antipsychotics|04/10/2016| 65862087760|CE:APY-SGA|Antipsychotics|04/10/2016| 65862088060|CE:SDF-REVATIO|Sildenafil (Revatio)|01/31/2011| 65862088830|CE:DRO-GLIP2.5|Drug Regimen Optimization|01/31/2011| 65862088901|CE:DRO-GLIP5|Drug Regimen Optimization|01/31/2011| 65862088905|CE:DRO-GLIP5|Drug Regimen Optimization|01/31/2011| 65862090760|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 65862090760|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 65862090801|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 65862090801|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 65862090901|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 65862090901|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 65862091060|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 65862091060|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 65862092201|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 65862092201|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 65862092201|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862092201|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862092205|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 65862092205|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862092205|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 65862092205|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 65862092836|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 65862094324|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 65862094424|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 65862094524|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 65862096701|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 65862096730|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 65862096801|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 65862096901|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 65862097603|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65862097603|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862097703|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862097703|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65862097803|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 65862097803|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 65862099830|CE:MOD-ARM|Modafinil (Provigil)|02/06/2018| 66302046760|CE:SDF-REVATIO|Sildenafil (Revatio)|01/31/2011| 66490065020|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 66582031131|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 66582031154|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 66582031231|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 66582031254|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 66582031331|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 66582031354|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 66582031531|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 66582031554|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 66658010260|CE:ENZ-NOR|Enzymes|11/20/2019| 66658010560|CE:ENZ-NOR|Enzymes|11/20/2019| 66658011060|CE:ENZ-NOR|Enzymes|11/20/2019| 66658012060|CE:ENZ-NOR|Enzymes|11/20/2019| 66658020490|CE:ENZ-NOR|Enzymes|11/20/2019| 66658023407|CE:CYC-KINE|Cytokine and CAM Antagonists|03/27/2018| 66689002304|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 66689002304|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 66689002304|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 66689002304|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 66689002316|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 66689002316|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 66689002316|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 66689002316|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 66689002530|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 66689002530|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 66689002530|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 66689033316|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 66689040316|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 66689040316|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 66689040316|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 66689040316|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 66869010490|CE:DUP-STN|Duplicate Therapy|02/04/2016| 66869020490|CE:DUP-STN|Duplicate Therapy|02/04/2016| 66869040490|CE:DUP-STN|Duplicate Therapy|02/04/2016| 66993001968|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 66993002127|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 66993002227|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 66993002327|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 66993003883|CE:MAK-MAK|Makena|06/12/2015| 66993004030|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 66993004130|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 66993004230|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 66993004330|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 66993004430|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 66993004530|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 66993004630|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 66993006785|CE:DRO-PNZ20|Drug Regimen Optimization|01/31/2011| 66993014130|CE:ASN-ALISK150|Aliskiren-Containing Agents|07/16/2012| 66993014230|CE:ASN-ALISK300|Aliskiren-Containing Agents|07/16/2012| 66993019395|CE:KET-KETNAS|Ketorolac|02/06/2018| 66993019395|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 66993035957|CE:ADD-IRPROC|ADD/ADHD Agents|02/13/2014| 66993042285|CE:FOS-FOSRENOL|Fosrenol (Lanthanum Carbonate)|01/31/2011| 66993042385|CE:FOS-FOSRENOL|Fosrenol (Lanthanum Carbonate)|01/31/2011| 66993042485|CE:FOS-FOSRENOL|Fosrenol (Lanthanum Carbonate)|01/31/2011| 66993048532|CE:LTMC-ZIL|Leukotriene Modifiers - Clinical|12/15/2015| 66993058497|CE:DUP-SALFL|Duplicate Therapy|02/05/2013| 66993058597|CE:DUP-SALFL|Duplicate Therapy|02/05/2013| 66993058697|CE:DUP-SALFL|Duplicate Therapy|02/05/2013| 66993059402|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 66993059402|CE:DRO-APHXL5|Drug Regimen Optimization|01/31/2011| 66993059502|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 66993059502|CE:DRO-APHXL10|Drug Regimen Optimization|01/31/2011| 66993059602|CE:DRO-APHXK15|Drug Regimen Optimization|01/31/2011| 66993059602|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 66993059702|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 66993059802|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 66993059902|CE:ADD-ERADDERA|ADD/ADHD Agents|02/13/2014| 66993066130|CE:DUP-RXF|Duplicate Therapy|02/04/2016| 66993066188|CE:DUP-RXF|Duplicate Therapy|02/04/2016| 66993068030|CE:DRO-OLANZ2.5|Drug Regimen Optimization|01/31/2011| 66993068030|CE:APY-SGA|Antipsychotics|04/10/2016| 66993068130|CE:DRO-OLANZ5|Drug Regimen Optimization|01/31/2011| 66993068130|CE:APY-SGA|Antipsychotics|04/10/2016| 66993068230|CE:APY-SGA|Antipsychotics|04/10/2016| 66993068230|CE:DRO-OLANZ7.5|Drug Regimen Optimization|01/31/2011| 66993068330|CE:DRO-OLANZ10|Drug Regimen Optimization|01/31/2011| 66993068330|CE:APY-SGA|Antipsychotics|04/10/2016| 66993068430|CE:APY-SGA|Antipsychotics|04/10/2016| 66993068530|CE:APY-SGA|Antipsychotics|04/10/2016| 66993082130|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 66993082230|CE:TZD-PIOGLIT|Hypoglycemics TZD|01/31/2011| 66993084462|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 66993084462|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 66993084562|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 66993084562|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 66993084662|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 66993084662|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 67253065110|CE:PTU-PTU|Propylthiouracil|04/18/2011| 67386042101|CE:VMAT-TET|VMAT2 Inhibitors|09/25/2018| 67386042201|CE:VMAT-TET|VMAT2 Inhibitors|09/25/2018| 67457012410|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 67457058210|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 67457058304|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 67457058406|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 67457058508|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 67457059406|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 67457096701|CE:MAK-MAK|Makena|06/12/2015| 67877011601|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 67877011601|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 67877011601|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 67877011601|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 67877011601|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 67877014601|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 67877014601|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 67877014601|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 67877014601|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 67877014605|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 67877014605|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 67877014605|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 67877014605|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 67877014701|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 67877014701|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 67877014701|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 67877014701|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 67877014705|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 67877014705|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 67877014705|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 67877014705|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 67877014801|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 67877014801|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 67877014801|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 67877014801|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 67877014930|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 67877014930|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 67877014930|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 67877014930|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 67877019705|CE:DRO-AMLOD2.5|Drug Regimen Optimization|01/31/2011| 67877019710|CE:DRO-AMLOD2.5|Drug Regimen Optimization|01/31/2011| 67877019790|CE:DRO-AMLOD2.5|Drug Regimen Optimization|01/31/2011| 67877019805|CE:DRO-AMLOD5|Drug Regimen Optimization|01/31/2011| 67877019810|CE:DRO-AMLOD5|Drug Regimen Optimization|01/31/2011| 67877019890|CE:DRO-AMLOD5|Drug Regimen Optimization|01/31/2011| 67877022201|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 67877022205|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 67877022210|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 67877022301|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 67877022305|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 67877022310|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 67877022401|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 67877022405|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 67877022410|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 67877024201|CE:APY-SGA|Antipsychotics|04/10/2016| 67877024210|CE:APY-SGA|Antipsychotics|04/10/2016| 67877024601|CE:APY-SGA|Antipsychotics|04/10/2016| 67877024610|CE:APY-SGA|Antipsychotics|04/10/2016| 67877024710|CE:APY-SGA|Antipsychotics|04/10/2016| 67877024760|CE:APY-SGA|Antipsychotics|04/10/2016| 67877024801|CE:APY-SGA|Antipsychotics|04/10/2016| 67877024810|CE:APY-SGA|Antipsychotics|04/10/2016| 67877024901|CE:APY-SGA|Antipsychotics|04/10/2016| 67877024910|CE:APY-SGA|Antipsychotics|04/10/2016| 67877025001|CE:APY-SGA|Antipsychotics|04/10/2016| 67877025010|CE:APY-SGA|Antipsychotics|04/10/2016| 67877031901|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 67877031905|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 67877032001|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 67877032005|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 67877032030|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 67877032050|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 67877032101|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 67877032105|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 67877032130|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 67877032150|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 67877041530|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 67877041690|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 67877041690|CE:DRO-VALSA80|Drug Regimen Optimization|01/31/2011| 67877041790|CE:DRO-VALSA160|Drug Regimen Optimization|01/31/2011| 67877041790|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 67877041890|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 67877042801|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 67877042805|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 67877042901|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 67877042905|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 67877043003|CE:APY-ARI|Antipsychotics|04/10/2016| 67877043005|CE:APY-ARI|Antipsychotics|04/10/2016| 67877043101|CE:APY-ARI|Antipsychotics|04/10/2016|10/31/2021 67877043101|CE:DRO-ARIPI5|Drug Regimen Optimization|01/31/2011|10/31/2021 67877043103|CE:DRO-ARIPI5|Drug Regimen Optimization|01/31/2011| 67877043103|CE:APY-ARI|Antipsychotics|04/10/2016| 67877043105|CE:APY-ARI|Antipsychotics|04/10/2016| 67877043105|CE:DRO-ARIPI5|Drug Regimen Optimization|01/31/2011| 67877043201|CE:DRO-ARIPI10|Drug Regimen Optimization|01/31/2011|03/31/2021 67877043201|CE:APY-ARI|Antipsychotics|04/10/2016|03/31/2021 67877043203|CE:DRO-ARIPI10|Drug Regimen Optimization|01/31/2011| 67877043203|CE:APY-ARI|Antipsychotics|04/10/2016| 67877043205|CE:DRO-ARIPI10|Drug Regimen Optimization|01/31/2011| 67877043205|CE:APY-ARI|Antipsychotics|04/10/2016| 67877043301|CE:DRO-ARIPI15|Drug Regimen Optimization|01/31/2011|01/31/2021 67877043301|CE:APY-ARI|Antipsychotics|04/10/2016|01/31/2021 67877043303|CE:DRO-ARIPI15|Drug Regimen Optimization|01/31/2011| 67877043303|CE:APY-ARI|Antipsychotics|04/10/2016| 67877043305|CE:APY-ARI|Antipsychotics|04/10/2016| 67877043305|CE:DRO-ARIPI15|Drug Regimen Optimization|01/31/2011| 67877043403|CE:APY-ARI|Antipsychotics|04/10/2016| 67877043405|CE:APY-ARI|Antipsychotics|04/10/2016| 67877043501|CE:APY-ARI|Antipsychotics|04/10/2016|03/31/2021 67877043503|CE:APY-ARI|Antipsychotics|04/10/2016| 67877043505|CE:APY-ARI|Antipsychotics|04/10/2016| 67877043990|CE:DUP-STN|Duplicate Therapy|02/04/2016| 67877043990|CE:DRO-ROSUV5|Drug Regimen Optimization|01/31/2011| 67877044005|CE:DRO-ROSUV10|Drug Regimen Optimization|01/31/2011| 67877044005|CE:DUP-STN|Duplicate Therapy|02/04/2016| 67877044090|CE:DRO-ROSUV10|Drug Regimen Optimization|01/31/2011| 67877044090|CE:DUP-STN|Duplicate Therapy|02/04/2016| 67877044190|CE:DUP-STN|Duplicate Therapy|02/04/2016| 67877044190|CE:DRO-ROSUV20|Drug Regimen Optimization|01/31/2011| 67877044230|CE:DUP-STN|Duplicate Therapy|02/04/2016| 67877044290|CE:DUP-STN|Duplicate Therapy|02/04/2016| 67877044530|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 67877044630|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 67877044630|CE:DRO-OLMES20|Drug Regimen Optimization|01/31/2011| 67877044690|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 67877044690|CE:DRO-OLMES20|Drug Regimen Optimization|01/31/2011| 67877044730|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 67877044790|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 67877047750|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 67877047810|CE:DRO-EMP20|Drug Regimen Optimization|01/31/2011| 67877047830|CE:DRO-EMP20|Drug Regimen Optimization|01/31/2011| 67877047890|CE:DRO-EMP20|Drug Regimen Optimization|01/31/2011| 67877048230|CE:DRO-TELMI20|Drug Regimen Optimization|01/31/2011| 67877048230|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 67877048284|CE:DRO-TELMI20|Drug Regimen Optimization|01/31/2011| 67877048284|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 67877048330|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 67877048330|CE:DRO-TELMI40|Drug Regimen Optimization|01/31/2011| 67877048384|CE:DRO-TELMI40|Drug Regimen Optimization|01/31/2011| 67877048384|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 67877048430|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 67877048484|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 67877050130|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 67877050230|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 67877050730|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 67877050790|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 67877050830|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 67877050890|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 67877050930|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 67877050990|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 67877051030|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 67877051090|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 67877051105|CE:DRO-ATORV10|Drug Regimen Optimization|01/31/2011| 67877051105|CE:DUP-STN|Duplicate Therapy|02/04/2016| 67877051190|CE:DUP-STN|Duplicate Therapy|02/04/2016| 67877051190|CE:DRO-ATORV10|Drug Regimen Optimization|01/31/2011| 67877051210|CE:DRO-ATORV20|Drug Regimen Optimization|01/31/2011| 67877051210|CE:DUP-STN|Duplicate Therapy|02/04/2016| 67877051290|CE:DRO-ATORV20|Drug Regimen Optimization|01/31/2011| 67877051290|CE:DUP-STN|Duplicate Therapy|02/04/2016| 67877051390|CE:DUP-STN|Duplicate Therapy|02/04/2016| 67877051390|CE:DRO-ATORV40|Drug Regimen Optimization|01/31/2011| 67877051405|CE:DUP-STN|Duplicate Therapy|02/04/2016| 67877051490|CE:DUP-STN|Duplicate Therapy|02/04/2016| 67877052730|CE:DRO-SOLAF5|Drug Regimen Optimization|01/31/2011| 67877052790|CE:DRO-SOLAF5|Drug Regimen Optimization|01/31/2011| 67877057301|CE:CCC-CCCC|Cough and Cold Agents - Clinical|12/15/2015| 67877057305|CE:CCC-CCCC|Cough and Cold Agents - Clinical|12/15/2015| 67877057401|CE:CCC-CCCC|Cough and Cold Agents - Clinical|12/15/2015| 67877057501|CE:CCC-CCCC|Cough and Cold Agents - Clinical|12/15/2015| 67877057505|CE:CCC-CCCC|Cough and Cold Agents - Clinical|12/15/2015| 68001000400|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 68001000400|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 68001000501|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 68001000501|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 68001000600|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011|01/28/2021 68001000603|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011|01/28/2021 68001000700|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011|01/15/2021 68001000703|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011|04/30/2021 68001010500|CE:DRO-DIVAL250|Drug Regimen Optimization|01/31/2011| 68001010503|CE:DRO-DIVAL250|Drug Regimen Optimization|01/31/2011| 68001011104|CE:DRO-LPZ15|Drug Regimen Optimization|01/31/2011| 68001011105|CE:DRO-LPZ15|Drug Regimen Optimization|01/31/2011| 68001013606|CE:APY-SGA|Antipsychotics|04/10/2016|07/31/2021 68001013706|CE:APY-SGA|Antipsychotics|04/10/2016|07/13/2021 68001013806|CE:APY-SGA|Antipsychotics|04/10/2016|07/31/2021 68001013906|CE:APY-SGA|Antipsychotics|04/10/2016|06/30/2021 68001014004|CE:DRO-RAMI1.25|Drug Regimen Optimization|01/31/2011|03/20/2021 68001014200|CE:DRO-RAMI2.50|Drug Regimen Optimization|01/31/2011|03/04/2021 68001014203|CE:DRO-RAMI2.50|Drug Regimen Optimization|01/31/2011|03/04/2021 68001014300|CE:DRO-RAMI5.00|Drug Regimen Optimization|01/31/2011|01/15/2021 68001014303|CE:DRO-RAMI5.00|Drug Regimen Optimization|01/31/2011|01/15/2021 68001015800|CE:DRO-VENL37.5|Drug Regimen Optimization|01/31/2011| 68001016100|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 68001016200|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 68001016208|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 68001016300|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 68001018000|CE:APY-SGA|Antipsychotics|04/10/2016| 68001018008|CE:APY-SGA|Antipsychotics|04/10/2016| 68001018100|CE:APY-SGA|Antipsychotics|04/10/2016| 68001018103|CE:APY-SGA|Antipsychotics|04/10/2016| 68001018200|CE:APY-SGA|Antipsychotics|04/10/2016| 68001018203|CE:APY-SGA|Antipsychotics|04/10/2016| 68001018300|CE:APY-SGA|Antipsychotics|04/10/2016| 68001018303|CE:APY-SGA|Antipsychotics|04/10/2016| 68001018306|CE:APY-SGA|Antipsychotics|04/10/2016| 68001018400|CE:APY-SGA|Antipsychotics|04/10/2016| 68001018408|CE:APY-SGA|Antipsychotics|04/10/2016| 68001018500|CE:APY-SGA|Antipsychotics|04/10/2016| 68001018508|CE:APY-SGA|Antipsychotics|04/10/2016| 68001019500|CE:DRO-ETP5|Drug Regimen Optimization|01/31/2011| 68001019600|CE:DRO-ETP10|Drug Regimen Optimization|01/31/2011| 68001019603|CE:DRO-ETP10|Drug Regimen Optimization|01/31/2011| 68001023106|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 68001023206|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 68001027900|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 68001028000|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 68001028006|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 68001028008|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 68001028100|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 68001028103|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 68001028106|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 68001028108|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 68001031400|CE:DRO-LOVA10|Drug Regimen Optimization|01/31/2011| 68001031400|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68001031500|CE:DRO-LOVA20|Drug Regimen Optimization|01/31/2011| 68001031500|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68001031508|CE:DRO-LOVA20|Drug Regimen Optimization|01/31/2011| 68001031508|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68001031600|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68001031608|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68001032203|CE:DRO-BUPR150|Drug Regimen Optimization|01/31/2011| 68001032204|CE:DRO-BUPR150|Drug Regimen Optimization|01/31/2011| 68001032205|CE:DRO-BUPR150|Drug Regimen Optimization|01/31/2011| 68001032500|CE:DES-DESMO|Desmopressin|05/25/2012| 68001032600|CE:DES-DESMO|Desmopressin|05/25/2012| 68001032700|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013|11/26/2020 68001032703|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013|12/31/2020 68001032803|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013|12/31/2020 68001036103|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 68001036105|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 68001036305|CE:SDF-REVATIO|Sildenafil (Revatio)|01/31/2011| 68001038700|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68001038703|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68001038800|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68001038803|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68001041100|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 68001041103|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 68001041200|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 68001041203|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 68001042800|CE:DRO-RAMI1.25|Drug Regimen Optimization|01/31/2011| 68001042900|CE:DRO-RAMI2.50|Drug Regimen Optimization|01/31/2011| 68001043000|CE:DRO-RAMI5.00|Drug Regimen Optimization|01/31/2011| 68001043003|CE:DRO-RAMI5.00|Drug Regimen Optimization|01/31/2011| 68025004610|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 68025004610|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 68025004710|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 68025004710|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 68025006530|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 68025006630|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 68025006730|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 68047012016|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 68047012016|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 68047012916|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 68047012916|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 68047012916|CE:DXO-DEXQ|Dextromethorphan Overutilization|07/16/2012| 68047014316|CE:DXO-DEXN|Dextromethorphan Overutilization|07/16/2012| 68047014316|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 68047014316|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 68047014316|CE:DXO-DEXQCHLD|Dextromethorphan Overutilization|07/16/2012| 68047018516|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 68047018516|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 68047018616|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 68047018616|CE:DXO-DEXN|Dextromethorphan Overutilization|07/16/2012| 68047018616|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 68047018616|CE:DXO-DEXO|Dextromethorphan Overutilization|07/16/2012| 68047070221|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 68047070221|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 68047070235|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 68047070235|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 68047070251|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 68047070251|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 68134020116|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 68135002001|CE:ENZ-NAG|Enzymes|11/20/2019| 68135010001|CE:ENZ-VIM|Enzymes|11/20/2019| 68180010102|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180010102|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68180010109|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68180010109|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180010202|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180010202|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68180010209|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180010209|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68180010302|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68180010302|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180010309|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180010309|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68180010402|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68180010402|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180010409|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180010409|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68180010502|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180010502|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68180010509|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180010509|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68180013415|CE:FOS-FOSRENOL|Fosrenol (Lanthanum Carbonate)|01/31/2011| 68180013501|CE:DRO-ETP10|Drug Regimen Optimization|01/31/2011| 68180013701|CE:DRO-ETP5|Drug Regimen Optimization|01/31/2011| 68180015301|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 68180015302|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 68180016916|CE:LTMC-ZIL|Leukotriene Modifiers - Clinical|12/15/2015| 68180018506|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 68180019306|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68180019306|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180019406|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68180019406|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180019506|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180019506|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68180019606|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180019706|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180019806|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180019906|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180021506|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180021506|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68180021506|CE:DRO-LORS12.5|Drug Regimen Optimization|01/31/2011| 68180021509|CE:DRO-LORS12.5|Drug Regimen Optimization|01/31/2011| 68180021509|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180021509|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68180021606|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180021606|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68180021609|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68180021609|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180021706|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180021706|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68180021709|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180021709|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68180022101|CE:DRO-NIASA500|Drug Regimen Optimization|01/31/2011| 68180022103|CE:DRO-NIASA500|Drug Regimen Optimization|01/31/2011| 68180026001|CE:DRO-DIVAL250|Drug Regimen Optimization|01/31/2011| 68180026002|CE:DRO-DIVAL250|Drug Regimen Optimization|01/31/2011| 68180031902|CE:DRO-BUPR150|Drug Regimen Optimization|01/31/2011| 68180031906|CE:DRO-BUPR150|Drug Regimen Optimization|01/31/2011| 68180031909|CE:DRO-BUPR150|Drug Regimen Optimization|01/31/2011| 68180032201|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 68180032301|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 68180032401|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 68180033107|CE:APY-SGA|Antipsychotics|04/10/2016| 68180033207|CE:APY-SGA|Antipsychotics|04/10/2016| 68180033307|CE:APY-SGA|Antipsychotics|04/10/2016| 68180033407|CE:APY-SGA|Antipsychotics|04/10/2016| 68180035103|CE:DRO-SRL25|Drug Regimen Optimization|01/31/2011| 68180035106|CE:DRO-SRL25|Drug Regimen Optimization|01/31/2011| 68180035109|CE:DRO-SRL25|Drug Regimen Optimization|01/31/2011| 68180035202|CE:DRO-SRL50|Drug Regimen Optimization|01/31/2011| 68180035205|CE:DRO-SRL50|Drug Regimen Optimization|01/31/2011| 68180035206|CE:DRO-SRL50|Drug Regimen Optimization|01/31/2011| 68180035209|CE:DRO-SRL50|Drug Regimen Optimization|01/31/2011| 68180035407|CE:RAN-RAN|Ranolazine|05/25/2012|07/31/2021 68180035507|CE:RAN-RAN|Ranolazine|05/25/2012|07/31/2021 68180037603|CE:DRO-LORSA25|Drug Regimen Optimization|01/31/2011| 68180037603|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180037703|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180037703|CE:DRO-LORSA50|Drug Regimen Optimization|01/31/2011| 68180037803|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180039507|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 68180039507|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 68180039601|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 68180039601|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 68180039602|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 68180039602|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 68180039701|CE:DUP-COXC|Duplicate Therapy|02/04/2016|01/16/2021 68180039701|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011|01/16/2021 68180039702|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011|02/24/2021 68180039702|CE:DUP-COXC|Duplicate Therapy|02/04/2016|02/24/2021 68180039807|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 68180039807|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 68180039901|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 68180039901|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 68180039902|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 68180039902|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 68180040858|CE:VMAT-TET|VMAT2 Inhibitors|09/25/2018|08/28/2021 68180040958|CE:VMAT-TET|VMAT2 Inhibitors|09/25/2018|08/28/2021 68180041006|CE:DRO-IRBE75|Drug Regimen Optimization|01/31/2011| 68180041006|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180041009|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180041009|CE:DRO-IRBE75|Drug Regimen Optimization|01/31/2011| 68180041106|CE:DRO-IRBE150|Drug Regimen Optimization|01/31/2011| 68180041106|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180041109|CE:DRO-IRBE150|Drug Regimen Optimization|01/31/2011| 68180041109|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180041206|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180041209|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180041306|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180041306|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68180041309|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68180041309|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180041406|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68180041406|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180041409|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180041409|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68180044501|CE:APY-SGA|Antipsychotics|04/10/2016| 68180044503|CE:APY-SGA|Antipsychotics|04/10/2016| 68180044601|CE:APY-SGA|Antipsychotics|04/10/2016| 68180044603|CE:APY-SGA|Antipsychotics|04/10/2016| 68180044701|CE:APY-SGA|Antipsychotics|04/10/2016| 68180044703|CE:APY-SGA|Antipsychotics|04/10/2016| 68180044801|CE:APY-SGA|Antipsychotics|04/10/2016| 68180044802|CE:APY-SGA|Antipsychotics|04/10/2016| 68180044901|CE:APY-SGA|Antipsychotics|04/10/2016| 68180044902|CE:APY-SGA|Antipsychotics|04/10/2016| 68180044907|CE:APY-SGA|Antipsychotics|04/10/2016| 68180045001|CE:APY-SGA|Antipsychotics|04/10/2016| 68180045002|CE:APY-SGA|Antipsychotics|04/10/2016| 68180046403|CE:DRO-SIMVA40|Drug Regimen Optimization|01/31/2011| 68180046403|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68180046406|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68180046406|CE:DRO-SIMVA40|Drug Regimen Optimization|01/31/2011| 68180046409|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68180046409|CE:DRO-SIMVA40|Drug Regimen Optimization|01/31/2011| 68180046503|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68180046506|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68180046509|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68180046701|CE:DRO-LOVA10|Drug Regimen Optimization|01/31/2011| 68180046701|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68180046703|CE:DRO-LOVA10|Drug Regimen Optimization|01/31/2011| 68180046703|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68180046707|CE:DRO-LOVA10|Drug Regimen Optimization|01/31/2011| 68180046707|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68180046801|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68180046801|CE:DRO-LOVA20|Drug Regimen Optimization|01/31/2011| 68180046803|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68180046803|CE:DRO-LOVA20|Drug Regimen Optimization|01/31/2011| 68180046805|CE:DRO-LOVA20|Drug Regimen Optimization|01/31/2011| 68180046805|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68180046807|CE:DRO-LOVA20|Drug Regimen Optimization|01/31/2011| 68180046807|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68180046901|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68180046903|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68180046905|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68180046907|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68180047801|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68180047801|CE:DRO-SIMVA10|Drug Regimen Optimization|01/31/2011| 68180047802|CE:DRO-SIMVA10|Drug Regimen Optimization|01/31/2011| 68180047802|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68180047803|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68180047803|CE:DRO-SIMVA10|Drug Regimen Optimization|01/31/2011| 68180047901|CE:DRO-SIMVA20|Drug Regimen Optimization|01/31/2011| 68180047901|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68180047902|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68180047902|CE:DRO-SIMVA20|Drug Regimen Optimization|01/31/2011| 68180047903|CE:DRO-SIMVA20|Drug Regimen Optimization|01/31/2011| 68180047903|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68180048502|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68180048502|CE:DRO-PRAVA10|Drug Regimen Optimization|01/31/2011| 68180048509|CE:DRO-PRAVA10|Drug Regimen Optimization|01/31/2011| 68180048509|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68180048602|CE:DRO-PRAVA20|Drug Regimen Optimization|01/31/2011| 68180048602|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68180048609|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68180048609|CE:DRO-PRAVA20|Drug Regimen Optimization|01/31/2011| 68180048702|CE:DRO-PRAVA40|Drug Regimen Optimization|01/31/2011| 68180048702|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68180048709|CE:DRO-PRAVA40|Drug Regimen Optimization|01/31/2011| 68180048709|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68180048802|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68180048809|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68180049001|CE:DUP-MGL|Duplicate Therapy|02/05/2013| 68180049101|CE:DUP-MGL|Duplicate Therapy|02/05/2013| 68180050101|CE:COX-MOBIC|COX-2 Inhibitors|01/31/2011| 68180050101|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 68180050101|CE:DRO-MELOX7.5|Drug Regimen Optimization|01/31/2011| 68180050103|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 68180050103|CE:COX-MOBIC|COX-2 Inhibitors|01/31/2011| 68180050103|CE:DRO-MELOX7.5|Drug Regimen Optimization|01/31/2011| 68180050201|CE:COX-MOBIC|COX-2 Inhibitors|01/31/2011| 68180050201|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 68180050203|CE:COX-MOBIC|COX-2 Inhibitors|01/31/2011| 68180050203|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 68180051801|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68180051802|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68180051830|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68180051901|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68180051902|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68180051930|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68180052001|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68180052002|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68180052030|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68180053801|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 68180056601|CE:DRO-TRANDOL1|Drug Regimen Optimization|01/31/2011| 68180056701|CE:DRO-TRANDOL2|Drug Regimen Optimization|01/31/2011| 68180056907|CE:MOD-ARM|Modafinil (Provigil)|02/06/2018| 68180057107|CE:MOD-ARM|Modafinil (Provigil)|02/06/2018| 68180057207|CE:MOD-ARM|Modafinil (Provigil)|02/06/2018| 68180057307|CE:MOD-ARM|Modafinil (Provigil)|02/06/2018| 68180058901|CE:DRO-RAMI2.50|Drug Regimen Optimization|01/31/2011| 68180058902|CE:DRO-RAMI2.50|Drug Regimen Optimization|01/31/2011| 68180058909|CE:DRO-RAMI2.50|Drug Regimen Optimization|01/31/2011| 68180059001|CE:DRO-RAMI5.00|Drug Regimen Optimization|01/31/2011| 68180059002|CE:DRO-RAMI5.00|Drug Regimen Optimization|01/31/2011| 68180059009|CE:DRO-RAMI5.00|Drug Regimen Optimization|01/31/2011| 68180060607|CE:ADD-KAPVAY|ADD/ADHD Agents|02/13/2014| 68180061207|CE:APY-SGA|Antipsychotics|04/10/2016| 68180061307|CE:APY-SGA|Antipsychotics|04/10/2016| 68180061407|CE:APY-SGA|Antipsychotics|04/10/2016| 68180061507|CE:APY-SGA|Antipsychotics|04/10/2016| 68180061607|CE:APY-SGA|Antipsychotics|04/10/2016| 68180063502|CE:DRO-ATORV10|Drug Regimen Optimization|01/31/2011| 68180063502|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68180063509|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68180063509|CE:DRO-ATORV10|Drug Regimen Optimization|01/31/2011| 68180063602|CE:DRO-ATORV20|Drug Regimen Optimization|01/31/2011| 68180063602|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68180063609|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68180063609|CE:DRO-ATORV20|Drug Regimen Optimization|01/31/2011| 68180063702|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68180063702|CE:DRO-ATORV40|Drug Regimen Optimization|01/31/2011| 68180063709|CE:DRO-ATORV40|Drug Regimen Optimization|01/31/2011| 68180063709|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68180063802|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68180063809|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68180064706|CE:DRO-PRX12.5|Drug Regimen Optimization|01/31/2011| 68180069706|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 68180069706|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 68180069706|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 68180069706|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 68180069806|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 68180069806|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 68180069806|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 68180069806|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 68180069906|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 68180069906|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 68180071909|CE:DRO-AMLOD2.5|Drug Regimen Optimization|01/31/2011| 68180072003|CE:DRO-AMLOD5|Drug Regimen Optimization|01/31/2011| 68180072009|CE:DRO-AMLOD5|Drug Regimen Optimization|01/31/2011| 68180076406|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180076506|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180076606|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180076706|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180077106|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68180077106|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180077109|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180077109|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68180077206|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68180077206|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180077209|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180077209|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68180077306|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180077306|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68180077309|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180077309|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68180077406|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180077406|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68180077409|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180077409|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68180077506|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180077506|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68180077509|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68180077509|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68180077901|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 68180078001|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 68180081942|CE:FOS-FOSRENOL|Fosrenol (Lanthanum Carbonate)|01/31/2011| 68180082046|CE:FOS-FOSRENOL|Fosrenol (Lanthanum Carbonate)|01/31/2011| 68180082147|CE:FOS-FOSRENOL|Fosrenol (Lanthanum Carbonate)|01/31/2011| 68180082709|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 68180082713|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 68180082809|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 68180082813|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 68180082913|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 68180083013|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 68180091407|CE:SDF-REVATIO|Sildenafil (Revatio)|01/31/2011| 68180096301|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 68308002003|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 68308002003|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 68308002003|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 68308011501|CE:ADD-IRMETHAM|ADD/ADHD Agents|02/13/2014| 68308014501|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 68308014501|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 68308014501|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 68308014501|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 68308047547|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 68308047547|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 68308047547|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 68308047547|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 68308048047|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 68308048047|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 68308048047|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 68308048047|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 68308084501|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 68308084501|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 68308084501|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 68308084501|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 68382001901|CE:DRO-VENL37.5|Drug Regimen Optimization|01/31/2011| 68382003406|CE:DRO-VENL37.5|Drug Regimen Optimization|01/31/2011|11/30/2020 68382003410|CE:DRO-VENL37.5|Drug Regimen Optimization|01/31/2011| 68382003416|CE:DRO-VENL37.5|Drug Regimen Optimization|01/31/2011| 68382003506|CE:DRO-VENL75|Drug Regimen Optimization|01/31/2011|01/31/2021 68382003510|CE:DRO-VENL75|Drug Regimen Optimization|01/31/2011| 68382003516|CE:DRO-VENL75|Drug Regimen Optimization|01/31/2011| 68382004001|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 68382004101|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 68382004110|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 68382004201|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 68382005001|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 68382005001|CE:COX-MOBIC|COX-2 Inhibitors|01/31/2011| 68382005001|CE:DRO-MELOX7.5|Drug Regimen Optimization|01/31/2011| 68382005005|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 68382005005|CE:DRO-MELOX7.5|Drug Regimen Optimization|01/31/2011| 68382005005|CE:COX-MOBIC|COX-2 Inhibitors|01/31/2011| 68382005101|CE:COX-MOBIC|COX-2 Inhibitors|01/31/2011| 68382005101|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 68382005105|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 68382005105|CE:COX-MOBIC|COX-2 Inhibitors|01/31/2011| 68382007005|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68382007005|CE:DRO-PRAVA10|Drug Regimen Optimization|01/31/2011| 68382007016|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68382007016|CE:DRO-PRAVA10|Drug Regimen Optimization|01/31/2011| 68382007105|CE:DRO-PRAVA20|Drug Regimen Optimization|01/31/2011| 68382007105|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68382007116|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68382007116|CE:DRO-PRAVA20|Drug Regimen Optimization|01/31/2011| 68382007205|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68382007205|CE:DRO-PRAVA40|Drug Regimen Optimization|01/31/2011| 68382007216|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68382007216|CE:DRO-PRAVA40|Drug Regimen Optimization|01/31/2011| 68382007901|CE:APY-FGA|Antipsychotics|04/10/2016| 68382007910|CE:APY-FGA|Antipsychotics|04/10/2016| 68382008001|CE:APY-FGA|Antipsychotics|04/10/2016| 68382008101|CE:APY-FGA|Antipsychotics|04/10/2016| 68382009705|CE:DRO-PRX10|Drug Regimen Optimization|01/31/2011| 68382009706|CE:DRO-PRX10|Drug Regimen Optimization|01/31/2011| 68382009710|CE:DRO-PRX10|Drug Regimen Optimization|01/31/2011| 68382009716|CE:DRO-PRX10|Drug Regimen Optimization|01/31/2011| 68382009801|CE:DRO-PRX20|Drug Regimen Optimization|01/31/2011| 68382009805|CE:DRO-PRX20|Drug Regimen Optimization|01/31/2011| 68382009806|CE:DRO-PRX20|Drug Regimen Optimization|01/31/2011| 68382009810|CE:DRO-PRX20|Drug Regimen Optimization|01/31/2011| 68382009816|CE:DRO-PRX20|Drug Regimen Optimization|01/31/2011| 68382011205|CE:DRO-RISP0.25|Drug Regimen Optimization|01/31/2011| 68382011205|CE:APY-ARI|Antipsychotics|04/10/2016| 68382011214|CE:DRO-RISP0.25|Drug Regimen Optimization|01/31/2011| 68382011214|CE:APY-ARI|Antipsychotics|04/10/2016| 68382011305|CE:DRO-RISP0.5|Drug Regimen Optimization|01/31/2011| 68382011305|CE:APY-ARI|Antipsychotics|04/10/2016| 68382011314|CE:APY-ARI|Antipsychotics|04/10/2016| 68382011314|CE:DRO-RISP0.5|Drug Regimen Optimization|01/31/2011| 68382011405|CE:APY-ARI|Antipsychotics|04/10/2016| 68382011405|CE:DRO-RISP1|Drug Regimen Optimization|01/31/2011| 68382011414|CE:DRO-RISP1|Drug Regimen Optimization|01/31/2011| 68382011414|CE:APY-ARI|Antipsychotics|04/10/2016| 68382011505|CE:APY-ARI|Antipsychotics|04/10/2016| 68382011505|CE:DRO-RISP2|Drug Regimen Optimization|01/31/2011| 68382011514|CE:APY-ARI|Antipsychotics|04/10/2016| 68382011514|CE:DRO-RISP2|Drug Regimen Optimization|01/31/2011| 68382011605|CE:APY-ARI|Antipsychotics|04/10/2016| 68382011614|CE:APY-ARI|Antipsychotics|04/10/2016| 68382011705|CE:APY-ARI|Antipsychotics|04/10/2016| 68382011714|CE:APY-ARI|Antipsychotics|04/10/2016| 68382012105|CE:DRO-AMLOD2.5|Drug Regimen Optimization|01/31/2011| 68382012116|CE:DRO-AMLOD2.5|Drug Regimen Optimization|01/31/2011| 68382012205|CE:DRO-AMLOD5|Drug Regimen Optimization|01/31/2011| 68382012216|CE:DRO-AMLOD5|Drug Regimen Optimization|01/31/2011| 68382013506|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68382013506|CE:DRO-LORSA25|Drug Regimen Optimization|01/31/2011| 68382013510|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68382013510|CE:DRO-LORSA25|Drug Regimen Optimization|01/31/2011| 68382013516|CE:DRO-LORSA25|Drug Regimen Optimization|01/31/2011| 68382013516|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68382013606|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68382013606|CE:DRO-LORSA50|Drug Regimen Optimization|01/31/2011| 68382013610|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68382013610|CE:DRO-LORSA50|Drug Regimen Optimization|01/31/2011| 68382013616|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68382013616|CE:DRO-LORSA50|Drug Regimen Optimization|01/31/2011| 68382013706|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68382013710|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68382013716|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68382014406|CE:DRO-RAMI1.25|Drug Regimen Optimization|01/31/2011| 68382014501|CE:DRO-RAMI2.50|Drug Regimen Optimization|01/31/2011| 68382014601|CE:DRO-RAMI5.00|Drug Regimen Optimization|01/31/2011| 68382020401|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 68382020405|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 68382020501|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 68382020505|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 68382024701|CE:CCC-CCCC|Cough and Cold Agents - Clinical|12/15/2015| 68382024705|CE:CCC-CCCC|Cough and Cold Agents - Clinical|12/15/2015| 68382025501|CE:DRO-OXYBU5|Drug Regimen Optimization|01/31/2011| 68382025505|CE:DRO-OXYBU5|Drug Regimen Optimization|01/31/2011| 68382027101|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 68382027114|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 68382027201|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 68382027301|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 68382027314|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 68382031901|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 68382031901|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 68382031901|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 68382031901|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 68382031910|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 68382031910|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 68382031910|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 68382031910|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 68382033401|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 68382033401|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 68382033401|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 68382033401|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 68382033405|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 68382033405|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 68382033405|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 68382033405|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 68382033506|CE:DRO-GLIP2.5|Drug Regimen Optimization|01/31/2011| 68382033601|CE:DRO-GLIP5|Drug Regimen Optimization|01/31/2011| 68382035305|CE:DRO-BUPR150|Drug Regimen Optimization|01/31/2011| 68382035306|CE:DRO-BUPR150|Drug Regimen Optimization|01/31/2011| 68382035316|CE:DRO-BUPR150|Drug Regimen Optimization|01/31/2011| 68382041101|CE:DRO-OMP10|Drug Regimen Optimization|01/31/2011| 68382041205|CE:DRO-OMP20|Drug Regimen Optimization|01/31/2011| 68382047178|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68382047178|CE:DRO-TELMI20|Drug Regimen Optimization|01/31/2011| 68382047278|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68382047278|CE:DRO-TELMI40|Drug Regimen Optimization|01/31/2011| 68382047378|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68382054306|CE:DRO-LPZ15|Drug Regimen Optimization|01/31/2011|04/30/2021 68382054310|CE:DRO-LPZ15|Drug Regimen Optimization|01/31/2011| 68382072116|CE:DUP-MGL|Duplicate Therapy|02/05/2013| 68382072216|CE:DUP-MGL|Duplicate Therapy|02/05/2013| 68382078301|CE:DRO-DOXA1|Drug Regimen Optimization|01/31/2011| 68382078401|CE:DRO-DOXA2|Drug Regimen Optimization|01/31/2011| 68382078501|CE:DRO-DOXA4|Drug Regimen Optimization|01/31/2011| 68382079301|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|10/31/2021 68382079301|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020|10/31/2021 68382079301|CE:OPO-OOVU|Opiate Overutilization|11/05/2013|10/31/2021 68382079301|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|10/31/2021 68382079401|CE:OPO-OOVU|Opiate Overutilization|11/05/2013|04/30/2021 68382079401|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020|04/30/2021 68382079401|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|04/30/2021 68382079401|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|04/30/2021 68382079501|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|05/31/2021 68382079501|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|05/31/2021 68382079501|CE:OPO-OOVU|Opiate Overutilization|11/05/2013|05/31/2021 68382079501|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020|05/31/2021 68382079601|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020|04/30/2021 68382079601|CE:OPO-OOVU|Opiate Overutilization|11/05/2013|04/30/2021 68382079601|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|04/30/2021 68382079601|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|04/30/2021 68382085601|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68382085605|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68382085701|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68382085705|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68382091601|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 68382091601|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 68382091634|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 68382091634|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 68382091711|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 68382091711|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 68382091818|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 68382091818|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 68382091911|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 68382091911|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 68382095001|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 68382095101|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 68382095201|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 68382095301|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 68382095401|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 68382095501|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 68382095601|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 68462011233|CE:AEM-ANTIEME|Antiemetics Oral|01/31/2011| 68462012601|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 68462012605|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 68462012701|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 68462012705|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 68462017801|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 68462017901|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 68462017905|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 68462018801|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 68462018805|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 68462018901|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 68462018905|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 68462019001|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 68462019005|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 68462019030|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 68462019505|CE:DRO-PRAVA10|Drug Regimen Optimization|01/31/2011| 68462019505|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68462019590|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68462019590|CE:DRO-PRAVA10|Drug Regimen Optimization|01/31/2011| 68462019605|CE:DRO-PRAVA20|Drug Regimen Optimization|01/31/2011| 68462019605|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68462019690|CE:DRO-PRAVA20|Drug Regimen Optimization|01/31/2011| 68462019690|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68462019705|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68462019705|CE:DRO-PRAVA40|Drug Regimen Optimization|01/31/2011| 68462019790|CE:DRO-PRAVA40|Drug Regimen Optimization|01/31/2011| 68462019790|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68462019805|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68462019890|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68462019913|CE:DRO-TELMI20|Drug Regimen Optimization|01/31/2011| 68462019913|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68462020013|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68462020013|CE:DRO-TELMI40|Drug Regimen Optimization|01/31/2011| 68462020113|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68462020401|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020|04/01/2021 68462020401|CE:OPO-OOVU|Opiate Overutilization|11/05/2013|04/01/2021 68462020401|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|04/01/2021 68462020401|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|04/01/2021 68462023301|CE:DRO-FLP2.5|Drug Regimen Optimization|01/31/2011| 68462023401|CE:DRO-FLP5|Drug Regimen Optimization|01/31/2011| 68462026190|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68462026190|CE:DRO-ROSUV5|Drug Regimen Optimization|01/31/2011| 68462026290|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68462026290|CE:DRO-ROSUV10|Drug Regimen Optimization|01/31/2011| 68462026390|CE:DRO-ROSUV20|Drug Regimen Optimization|01/31/2011| 68462026390|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68462026430|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68462026530|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 68462026630|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 68462026730|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 68462026830|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 68462026930|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 68462027030|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 68462027130|CE:ADD-NSADHD|ADD/ADHD Agents|02/13/2014| 68462027501|CE:DES-DESMO|Desmopressin|05/25/2012| 68462027601|CE:DES-DESMO|Desmopressin|05/25/2012| 68462030201|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 68462030205|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 68462031960|CE:RAN-RAN|Ranolazine|05/25/2012| 68462032060|CE:RAN-RAN|Ranolazine|05/25/2012| 68462032130|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 68462032230|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 68462032290|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 68462032330|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 68462032430|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 68462032501|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 68462032560|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 68462032590|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 68462034690|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 68462034737|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|04/01/2021 68462034737|CE:OPO-OOVU|Opiate Overutilization|11/05/2013|04/01/2021 68462034737|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|04/01/2021 68462035594|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 68462035601|CE:DUP-MLX|Duplicate Therapy|02/05/2013| 68462035801|CE:DUP-NSD|Duplicate Therapy|02/05/2013|03/13/2021 68462035805|CE:DUP-NSD|Duplicate Therapy|02/05/2013|01/31/2021 68462035901|CE:DUP-NSD|Duplicate Therapy|02/05/2013|02/10/2021 68462035905|CE:DUP-NSD|Duplicate Therapy|02/05/2013|02/10/2021 68462038001|CE:DUP-MLX|Duplicate Therapy|02/05/2013| 68462038201|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 68462038301|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 68462038401|CE:ASH-SEDHYP19|Anxiolytics Sedatives and Hypnotics|01/31/2011| 68462038630|CE:DRO-SOLAF5|Drug Regimen Optimization|01/31/2011| 68462038690|CE:DRO-SOLAF5|Drug Regimen Optimization|01/31/2011| 68462039501|CE:DRO-OMP10|Drug Regimen Optimization|01/31/2011| 68462039530|CE:DRO-OMP10|Drug Regimen Optimization|01/31/2011| 68462039590|CE:DRO-OMP10|Drug Regimen Optimization|01/31/2011| 68462039601|CE:DRO-OMP20|Drug Regimen Optimization|01/31/2011| 68462039610|CE:DRO-OMP20|Drug Regimen Optimization|01/31/2011| 68462039630|CE:DRO-OMP20|Drug Regimen Optimization|01/31/2011| 68462039690|CE:DRO-OMP20|Drug Regimen Optimization|01/31/2011| 68462040601|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 68462040610|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 68462043630|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68462043730|CE:DRO-OLMES20|Drug Regimen Optimization|01/31/2011| 68462043730|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68462043790|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68462043790|CE:DRO-OLMES20|Drug Regimen Optimization|01/31/2011| 68462043830|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68462043890|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68462053435|CE:TIM-PRO|Topical Immunomodulators ( Elidel & Protopic)|01/31/2011| 68462053465|CE:TIM-PRO|Topical Immunomodulators ( Elidel & Protopic)|01/31/2011| 68462053494|CE:TIM-PRO|Topical Immunomodulators ( Elidel & Protopic)|01/31/2011| 68462053670|CE:IMI-IMIQ5|Imiquimod|07/16/2012| 68462055401|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68462055501|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68462056630|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68462056690|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68462056730|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68462056790|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68462056830|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68462056890|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68462056930|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68462056990|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68462058340|CE:AEM-ANTIEME|Antiemetics Oral|01/31/2011| 68462058385|CE:AEM-ANTIEME|Antiemetics Oral|01/31/2011| 68462058458|CE:AEM-ANTIEME|Antiemetics Oral|01/31/2011| 68462058476|CE:AEM-ANTIEME|Antiemetics Oral|01/31/2011| 68462058576|CE:AEM-ANTIEME|Antiemetics Oral|01/31/2011| 68462060935|CE:TIM-TIM|Topical Immunomodulators ( Elidel & Protopic)|01/31/2011| 68462060965|CE:TIM-TIM|Topical Immunomodulators ( Elidel & Protopic)|01/31/2011| 68462060994|CE:TIM-TIM|Topical Immunomodulators ( Elidel & Protopic)|01/31/2011| 68462065629|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 68462065684|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 68462065729|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 68462065784|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 68462065790|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 68462071171|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 68462071188|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 68462072401|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 68462072401|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 68462072501|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 68462072501|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 68462080001|CE:OPO-OOVU|Opiate Overutilization|11/05/2013|04/01/2021 68462080001|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020|04/01/2021 68462080001|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|04/01/2021 68462080001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|04/01/2021 68462080101|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|04/01/2021 68462080101|CE:OPO-OOVU|Opiate Overutilization|11/05/2013|04/01/2021 68462080101|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020|04/01/2021 68462080101|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020|04/01/2021 68462080101|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|04/01/2021 68546017060|CE:VMAT-DEU|VMAT2 Inhibitors|09/25/2018| 68546017160|CE:VMAT-DEU|VMAT2 Inhibitors|09/25/2018| 68546017260|CE:VMAT-DEU|VMAT2 Inhibitors|09/25/2018| 68645045854|CE:DRO-ATORV10|Drug Regimen Optimization|01/31/2011|06/30/2021 68645045854|CE:DUP-STN|Duplicate Therapy|02/04/2016|06/30/2021 68645045954|CE:DUP-STN|Duplicate Therapy|02/04/2016|06/30/2021 68645045954|CE:DRO-ATORV20|Drug Regimen Optimization|01/31/2011|06/30/2021 68645046054|CE:DRO-ATORV40|Drug Regimen Optimization|01/31/2011|04/30/2021 68645046054|CE:DUP-STN|Duplicate Therapy|02/04/2016|04/30/2021 68645046154|CE:DUP-STN|Duplicate Therapy|02/04/2016|04/30/2021 68645047054|CE:DRO-SIMVA20|Drug Regimen Optimization|01/31/2011| 68645047054|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68645048054|CE:DRO-ATORV10|Drug Regimen Optimization|01/31/2011|06/30/2022 68645048054|CE:DUP-STN|Duplicate Therapy|02/04/2016|06/30/2022 68645048154|CE:DUP-STN|Duplicate Therapy|02/04/2016|06/30/2022 68645048154|CE:DRO-ATORV20|Drug Regimen Optimization|01/31/2011|06/30/2022 68645049454|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68645049454|CE:DRO-LORSA50|Drug Regimen Optimization|01/31/2011| 68645049554|CE:DUP-STN|Duplicate Therapy|02/04/2016|06/30/2022 68645051054|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68645051254|CE:DRO-NFP30|Drug Regimen Optimization|01/31/2011| 68645051554|CE:DRO-AMLOD5|Drug Regimen Optimization|01/31/2011| 68645051790|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|11/23/2020 68645051790|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|11/23/2020 68645051790|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011|11/23/2020 68645051890|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 68645051890|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011| 68645051890|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 68645051954|CE:DRO-ETP10|Drug Regimen Optimization|01/31/2011| 68645052154|CE:DRO-SRL25|Drug Regimen Optimization|01/31/2011| 68645052254|CE:DRO-SRL50|Drug Regimen Optimization|01/31/2011| 68645052754|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68645052754|CE:DRO-SIMVA40|Drug Regimen Optimization|01/31/2011| 68645055654|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68645055754|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68645055854|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68645056354|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 68645056690|CE:DRO-LOVA20|Drug Regimen Optimization|01/31/2011| 68645056690|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68645056790|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68645056854|CE:DUP-STN|Duplicate Therapy|02/04/2016|05/31/2022 68645056854|CE:DRO-ATORV40|Drug Regimen Optimization|01/31/2011|05/31/2022 68645056954|CE:DRO-CTP10|Drug Regimen Optimization|01/31/2011| 68645057054|CE:DRO-CTP20|Drug Regimen Optimization|01/31/2011| 68645058654|CE:DRO-LORSA50|Drug Regimen Optimization|01/31/2011| 68645058654|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 68645058854|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 68645059154|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68645059154|CE:DRO-ATORV20|Drug Regimen Optimization|01/31/2011| 68645059254|CE:DRO-ATORV40|Drug Regimen Optimization|01/31/2011| 68645059254|CE:DUP-STN|Duplicate Therapy|02/04/2016| 68682010301|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 68682010510|CE:DRO-NFP30|Drug Regimen Optimization|01/31/2011| 68682010830|CE:DRO-NFP30|Drug Regimen Optimization|01/31/2011| 68682011001|CE:TIM-TIM|Topical Immunomodulators ( Elidel & Protopic)|01/31/2011| 68682011102|CE:TIM-TIM|Topical Immunomodulators ( Elidel & Protopic)|01/31/2011| 68682011203|CE:TIM-TIM|Topical Immunomodulators ( Elidel & Protopic)|01/31/2011| 68682027275|CE:IMI-IMIQ|Imiquimod|07/16/2012| 68682042112|CE:VMAT-TET|VMAT2 Inhibitors|09/25/2018| 68682042225|CE:VMAT-TET|VMAT2 Inhibitors|09/25/2018| 68682065020|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 68682065220|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 68682065520|CE:ASH-CLO/DIAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 68727010001|CE:XYR-XYR|Xyrem|02/17/2011| 68727035001|CE:CNS-SOL|CNS Stimulants|04/14/2020| 68727035101|CE:CNS-SOL|CNS Stimulants|04/14/2020| 68968017203|CE:APY-SGA|Antipsychotics|04/10/2016| 68968017303|CE:APY-SGA|Antipsychotics|04/10/2016| 68968017403|CE:APY-SGA|Antipsychotics|04/10/2016| 68968051408|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 68968052508|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 68968341008|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 68968342508|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 68968343708|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 68968345008|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 68968347508|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 68968555203|CE:DRO-MPHPA10|Drug Regimen Optimization|01/31/2011| 68968555203|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 68968555303|CE:DRO-MPHPA15|Drug Regimen Optimization|01/31/2011| 68968555303|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 68968555403|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 68968555503|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 69097012605|CE:DRO-AMLOD2.5|Drug Regimen Optimization|01/31/2011| 69097012615|CE:DRO-AMLOD2.5|Drug Regimen Optimization|01/31/2011| 69097012705|CE:DRO-AMLOD5|Drug Regimen Optimization|01/31/2011| 69097012715|CE:DRO-AMLOD5|Drug Regimen Optimization|01/31/2011| 69097014260|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 69097015807|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 69097015807|CE:DRO-MELOX7.5|Drug Regimen Optimization|01/31/2011| 69097015807|CE:COX-MOBIC|COX-2 Inhibitors|01/31/2011| 69097015812|CE:DRO-MELOX7.5|Drug Regimen Optimization|01/31/2011| 69097015812|CE:COX-MOBIC|COX-2 Inhibitors|01/31/2011| 69097015812|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 69097015815|CE:DRO-MELOX7.5|Drug Regimen Optimization|01/31/2011| 69097015815|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 69097015815|CE:COX-MOBIC|COX-2 Inhibitors|01/31/2011| 69097015907|CE:COX-MOBIC|COX-2 Inhibitors|01/31/2011| 69097015907|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 69097015912|CE:COX-MOBIC|COX-2 Inhibitors|01/31/2011| 69097015912|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 69097015915|CE:COX-MOBIC|COX-2 Inhibitors|01/31/2011| 69097015915|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 69097017353|CE:DUP-LABAC|Duplicate Therapy|02/04/2016| 69097017364|CE:DUP-LABAC|Duplicate Therapy|02/04/2016| 69097025902|CE:DRO-SOLAF5|Drug Regimen Optimization|01/31/2011|10/30/2021 69097031887|CE:DUP-CRTROD|Duplicate Therapy|02/05/2013| 69097031953|CE:DUP-CRTROD|Duplicate Therapy|02/05/2013| 69097031987|CE:DUP-CRTROD|Duplicate Therapy|02/05/2013| 69097032153|CE:DUP-CRTROD|Duplicate Therapy|02/05/2013| 69097032187|CE:DUP-CRTROD|Duplicate Therapy|02/05/2013| 69097042107|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 69097042107|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 69097042112|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 69097042112|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 69097042207|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 69097042207|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 69097042212|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 69097042212|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 69097042303|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 69097042303|CE:COX-CELEBREX|COX-2 Inhibitors|01/31/2011| 69097043102|CE:DRO-DARI7.5|Drug Regimen Optimization|01/31/2011| 69097043105|CE:DRO-DARI7.5|Drug Regimen Optimization|01/31/2011| 69097052444|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 69097081107|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011|10/30/2021 69097081112|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011|10/30/2021 69097081207|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011|10/30/2021 69097081212|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011|10/30/2021 69097081307|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 69097081312|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 69097081507|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 69097081512|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 69097082207|CE:DRO-CTP10|Drug Regimen Optimization|01/31/2011| 69097082212|CE:DRO-CTP10|Drug Regimen Optimization|01/31/2011| 69097082307|CE:DRO-CTP20|Drug Regimen Optimization|01/31/2011| 69097082312|CE:DRO-CTP20|Drug Regimen Optimization|01/31/2011| 69097082502|CE:DUP-RXF|Duplicate Therapy|02/04/2016| 69097082507|CE:DUP-RXF|Duplicate Therapy|02/04/2016| 69097082515|CE:DUP-RXF|Duplicate Therapy|02/04/2016| 69097082805|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013|10/30/2021 69097082905|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013|10/30/2021 69097083105|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013|10/30/2021 69097083302|CE:DRO-SRL25|Drug Regimen Optimization|01/31/2011| 69097083305|CE:DRO-SRL25|Drug Regimen Optimization|01/31/2011| 69097083312|CE:DRO-SRL25|Drug Regimen Optimization|01/31/2011| 69097083402|CE:DRO-SRL50|Drug Regimen Optimization|01/31/2011| 69097083412|CE:DRO-SRL50|Drug Regimen Optimization|01/31/2011| 69097083605|CE:DRO-AMLOD2.5|Drug Regimen Optimization|01/31/2011| 69097083615|CE:DRO-AMLOD2.5|Drug Regimen Optimization|01/31/2011| 69097083705|CE:DRO-AMLOD5|Drug Regimen Optimization|01/31/2011| 69097083715|CE:DRO-AMLOD5|Drug Regimen Optimization|01/31/2011| 69097084507|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69097084507|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69097084507|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011| 69097084607|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69097084607|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69097084607|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011| 69097084615|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69097084615|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011| 69097084615|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69097084705|CE:DRO-ETP5|Drug Regimen Optimization|01/31/2011| 69097084805|CE:DRO-ETP10|Drug Regimen Optimization|01/31/2011| 69097085107|CE:DUP-NSD|Duplicate Therapy|02/05/2013|05/31/2021 69097085207|CE:DUP-NSD|Duplicate Therapy|02/05/2013|09/30/2021 69097085307|CE:DUP-NSD|Duplicate Therapy|02/05/2013|10/30/2021 69097085407|CE:DUP-NSD|Duplicate Therapy|02/05/2013|10/30/2021 69097085412|CE:DUP-NSD|Duplicate Therapy|02/05/2013|10/30/2021 69097085507|CE:DUP-NSD|Duplicate Therapy|02/05/2013|10/30/2021 69097085512|CE:DUP-NSD|Duplicate Therapy|02/05/2013|10/30/2021 69097085605|CE:DRO-FOSI10|Drug Regimen Optimization|01/31/2011| 69097085705|CE:DRO-FOSI20|Drug Regimen Optimization|01/31/2011| 69097086283|CE:FOS-FOSRENOL|Fosrenol (Lanthanum Carbonate)|01/31/2011| 69097087502|CE:DRO-BUPR150|Drug Regimen Optimization|01/31/2011| 69097087505|CE:DRO-BUPR150|Drug Regimen Optimization|01/31/2011| 69097087512|CE:DRO-BUPR150|Drug Regimen Optimization|01/31/2011| 69097094405|CE:DUP-STN|Duplicate Therapy|02/04/2016| 69097094405|CE:DRO-ATORV10|Drug Regimen Optimization|01/31/2011| 69097094415|CE:DRO-ATORV10|Drug Regimen Optimization|01/31/2011| 69097094415|CE:DUP-STN|Duplicate Therapy|02/04/2016| 69097094505|CE:DRO-ATORV20|Drug Regimen Optimization|01/31/2011| 69097094505|CE:DUP-STN|Duplicate Therapy|02/04/2016| 69097094512|CE:DUP-STN|Duplicate Therapy|02/04/2016| 69097094512|CE:DRO-ATORV20|Drug Regimen Optimization|01/31/2011| 69097094605|CE:DUP-STN|Duplicate Therapy|02/04/2016| 69097094605|CE:DRO-ATORV40|Drug Regimen Optimization|01/31/2011| 69097094615|CE:DUP-STN|Duplicate Therapy|02/04/2016| 69097094615|CE:DRO-ATORV40|Drug Regimen Optimization|01/31/2011| 69097094705|CE:DUP-STN|Duplicate Therapy|02/04/2016| 69097094712|CE:DUP-STN|Duplicate Therapy|02/04/2016| 69097096507|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 69097096512|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 69097096607|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 69097096612|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 69097096807|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 69097096812|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 69097096907|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 69097096912|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 69097097107|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 69097097112|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 69097097207|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 69097097307|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 69117002801|CE:DRO-FLP2.5|Drug Regimen Optimization|01/31/2011|12/31/2040 69117002802|CE:DRO-FLP2.5|Drug Regimen Optimization|01/31/2011|12/31/2040 69117002901|CE:DRO-FLP5|Drug Regimen Optimization|01/31/2011|12/31/2040 69117002902|CE:DRO-FLP5|Drug Regimen Optimization|01/31/2011|12/31/2040 69238105401|CE:APY-FGA|Antipsychotics|04/10/2016| 69238105601|CE:APY-FGA|Antipsychotics|04/10/2016| 69238105801|CE:APY-FGA|Antipsychotics|04/10/2016| 69238106001|CE:APY-FGA|Antipsychotics|04/10/2016| 69238106201|CE:APY-FGA|Antipsychotics|04/10/2016| 69238110105|CE:DUP-NSD|Duplicate Therapy|02/05/2013|02/26/2021 69238112001|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 69238115503|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 69238115603|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 69238115609|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013|10/17/2020 69238115703|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 69238115709|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013|10/17/2020 69238115803|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013| 69238115809|CE:DUP-STNCBO|Duplicate Therapy|02/05/2013|10/17/2020 69238120202|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69238120202|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 69238120202|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69238120202|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 69238120302|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 69238120302|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69238120302|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 69238120302|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69238120402|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 69238120402|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69238120402|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69238120502|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 69238120502|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69238120502|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69238120502|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 69238125206|CE:DUP-HRT|Duplicate Therapy|02/05/2013|12/17/2020 69238130803|CE:DRO-SOLAF5|Drug Regimen Optimization|01/31/2011|08/03/2021 69238130809|CE:DRO-SOLAF5|Drug Regimen Optimization|01/31/2011|08/03/2021 69238134201|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 69238134301|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 69238142606|CE:ADD-KAPVAY|ADD/ADHD Agents|02/13/2014| 69238150502|CE:OPC-MEDL|Opioid Policy Criteria|09/01/2020| 69238150502|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69238150502|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69238156301|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 69238156301|CE:ADD-IREVT|ADD/ADHD Agents|12/18/2019| 69238156401|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 69238156401|CE:ADD-IREVT|ADD/ADHD Agents|12/18/2019| 69238157401|CE:SDF-REVSUSP|Sildenafil (Revatio)|09/01/2015| 69238173002|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 69238179701|CE:MAK-MAK|Makena|06/12/2015| 69238199301|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 69238199301|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69238199301|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69238199301|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 69315013001|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 69315013010|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 69315013101|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 69315013110|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 69315015501|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 69315015510|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 69315024812|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69315024812|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 69315024812|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 69315024812|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69315024848|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 69315024848|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 69315024848|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69315024848|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69315090401|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69315090401|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69315090401|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69315090401|CE:ASH-LORAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 69315090405|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69315090405|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69315090405|CE:ASH-LORAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 69315090405|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69315090410|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69315090410|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69315090410|CE:ASH-LORAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 69315090410|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69315090501|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69315090501|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69315090501|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69315090501|CE:ASH-LORAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 69315090505|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69315090505|CE:ASH-LORAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 69315090505|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69315090505|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69315090510|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69315090510|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69315090510|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69315090510|CE:ASH-LORAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 69315090601|CE:ASH-LORAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 69315090601|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69315090601|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69315090601|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69315090605|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69315090605|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69315090605|CE:ASH-LORAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 69315090605|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69315090610|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69315090610|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69315090610|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69315090610|CE:ASH-LORAZ|Anxiolytics Sedatives and Hypnotics|01/31/2011| 69339013501|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013|11/23/2020 69339013510|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013|11/23/2020 69344010101|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 69367011901|CE:DRO-IRBE75|Drug Regimen Optimization|01/31/2011| 69367011901|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 69367011903|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 69367011903|CE:DRO-IRBE75|Drug Regimen Optimization|01/31/2011| 69367012001|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 69367012001|CE:DRO-IRBE150|Drug Regimen Optimization|01/31/2011| 69367012003|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 69367012003|CE:DRO-IRBE150|Drug Regimen Optimization|01/31/2011| 69367012101|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 69367012103|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 69367012204|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 69367012207|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 69367012304|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 69367012307|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 69367013104|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 69367013106|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 69367013204|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 69367013206|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 69367013304|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 69367013306|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 69367013404|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 69367013406|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 69367013504|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 69367013506|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 69367018408|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 69367018530|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 69367018650|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 69367018730|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 69367019760|CE:CCC-CCCA|Cough and Cold Agents - Clinical|12/15/2015| 69367019760|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 69367019890|CE:DXO-DEXAA|Dextromethorphan Overutilization|07/16/2012| 69367019890|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 69367019901|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 69367019901|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 69367021901|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 69367021905|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 69367021910|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 69367023809|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 69367023903|CE:DRO-SOLAF5|Drug Regimen Optimization|01/31/2011| 69367023909|CE:DRO-SOLAF5|Drug Regimen Optimization|01/31/2011| 69367024101|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 69367024105|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 69367024201|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 69367024205|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 69367024601|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 69367024610|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 69367025330|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 69452010513|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 69452010519|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 69452010532|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 69452010613|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 69452010619|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 69452010713|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 69452010719|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 69452011920|CE:DRO-OXYBU5|Drug Regimen Optimization|01/31/2011| 69452014320|CE:CCC-CCCC|Cough and Cold Agents - Clinical|12/15/2015| 69452014330|CE:CCC-CCCC|Cough and Cold Agents - Clinical|12/15/2015| 69452014420|CE:CCC-CCCC|Cough and Cold Agents - Clinical|12/15/2015| 69452014430|CE:CCC-CCCC|Cough and Cold Agents - Clinical|12/15/2015| 69452017522|CE:LVZ-LOVAZ|Lovaza|07/16/2012| 69452022720|CE:ADD-IREVT|ADD/ADHD Agents|12/18/2019| 69452022820|CE:ADD-IREVT|ADD/ADHD Agents|12/18/2019| 69543010710|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 69543010750|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 69543013610|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69543013610|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69543013610|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 69543013610|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 69543013611|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69543013611|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 69543013611|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 69543013611|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69543013650|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 69543013650|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69543013650|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69543013650|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 69543025116|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69543025116|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69543025116|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 69543025116|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 69543025204|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69543025204|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69543025204|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 69543025204|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 69543025216|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 69543025216|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69543025216|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69543025216|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 69543025304|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 69543025304|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 69543025304|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69543025304|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69543025316|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 69543025316|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 69543025316|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69543025316|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69543027616|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69543027616|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 69543027616|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69543027616|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 69543038030|CE:DRO-OLANZ2.5|Drug Regimen Optimization|01/31/2011| 69543038030|CE:APY-SGA|Antipsychotics|04/10/2016| 69543038090|CE:APY-SGA|Antipsychotics|04/10/2016| 69543038090|CE:DRO-OLANZ2.5|Drug Regimen Optimization|01/31/2011| 69543038130|CE:APY-SGA|Antipsychotics|04/10/2016| 69543038130|CE:DRO-OLANZ5|Drug Regimen Optimization|01/31/2011| 69543038190|CE:APY-SGA|Antipsychotics|04/10/2016| 69543038190|CE:DRO-OLANZ5|Drug Regimen Optimization|01/31/2011| 69543038230|CE:DRO-OLANZ7.5|Drug Regimen Optimization|01/31/2011| 69543038230|CE:APY-SGA|Antipsychotics|04/10/2016| 69543038290|CE:APY-SGA|Antipsychotics|04/10/2016| 69543038290|CE:DRO-OLANZ7.5|Drug Regimen Optimization|01/31/2011| 69543038330|CE:DRO-OLANZ10|Drug Regimen Optimization|01/31/2011| 69543038330|CE:APY-SGA|Antipsychotics|04/10/2016| 69543038390|CE:DRO-OLANZ10|Drug Regimen Optimization|01/31/2011| 69543038390|CE:APY-SGA|Antipsychotics|04/10/2016| 69543038430|CE:APY-SGA|Antipsychotics|04/10/2016| 69543038490|CE:APY-SGA|Antipsychotics|04/10/2016| 69543038530|CE:APY-SGA|Antipsychotics|04/10/2016| 69543038590|CE:APY-SGA|Antipsychotics|04/10/2016| 69543038810|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 69543038810|CE:KET-KET|Ketorolac|05/25/2012| 69543041210|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69543041210|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 69543041210|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 69543041210|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69543042510|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 69543042610|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 69584011110|CE:CCA-LDCARIS|Carisoprodol Containing Agents|01/31/2011| 69584011110|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69584011110|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69584011190|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69584011190|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69584011190|CE:CCA-LDCARIS|Carisoprodol Containing Agents|01/31/2011| 69584061110|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69584061110|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69584061150|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69584061150|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69584061210|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69584061210|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69584061250|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69584061250|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 69639010101|CE:AEM-ANTIEME|Antiemetics Oral|01/31/2011| 69784010201|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013|11/23/2020 69784050001|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 69784050101|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 69784055001|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 69809012605|CE:APY-SGA|Antipsychotics|04/10/2016| 69809012705|CE:APY-SGA|Antipsychotics|04/10/2016| 69918010101|CE:DES-DESMO|Desmopressin|05/25/2012| 69918020101|CE:DES-DESMO|Desmopressin|05/25/2012| 69918089910|CE:DES-DESMOINJ|Desmopressin|05/25/2012| 69918090110|CE:DES-DESMOINJ|Desmopressin|05/25/2012| 70000000101|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 70000000301|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 70000000401|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 70000000401|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 70000000402|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 70000000402|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 70000000601|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 70000000701|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 70000000701|CE:DXO-DEXQ|Dextromethorphan Overutilization|07/16/2012| 70000003201|CE:DRO-EMP20|Drug Regimen Optimization|01/31/2011| 70000003202|CE:DRO-EMP20|Drug Regimen Optimization|01/31/2011| 70000003203|CE:DRO-EMP20|Drug Regimen Optimization|01/31/2011| 70000004201|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 70000013101|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 70000013101|CE:DXO-DEXN|Dextromethorphan Overutilization|07/16/2012| 70000013101|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 70000013101|CE:DXO-DEXQCHLD|Dextromethorphan Overutilization|07/16/2012| 70000013301|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015|05/14/2021 70000013301|CE:DXO-DEXQ|Dextromethorphan Overutilization|07/16/2012|05/14/2021 70000013602|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 70000013603|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 70000014201|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013|11/23/2020 70000014401|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 70000016001|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 70000016001|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 70000016002|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 70000016002|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 70000016201|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 70000016202|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 70000017103|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 70000017502|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 70000017503|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 70000017504|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 70000017505|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 70000017602|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 70000017603|CE:DUP-NSD|Duplicate Therapy|02/05/2013|04/03/2021 70000018101|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 70000018801|CE:CCC-CCCA|Cough and Cold Agents - Clinical|12/15/2015|01/07/2021 70000018801|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013|01/07/2021 70000018901|CE:DXO-DEXQCHLD|Dextromethorphan Overutilization|07/16/2012| 70000018901|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 70000018901|CE:DXO-DEXN|Dextromethorphan Overutilization|07/16/2012| 70000018901|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 70000019101|CE:DXO-DEXVCHLD|Dextromethorphan Overutilization|07/16/2012| 70000019102|CE:DXO-DEXVCHLD|Dextromethorphan Overutilization|07/16/2012| 70000019501|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 70000019501|CE:DXO-DEXI|Dextromethorphan Overutilization|07/16/2012| 70000019501|CE:CCC-CCCA|Cough and Cold Agents - Clinical|12/15/2015| 70000020102|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 70000020103|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 70000020702|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 70000021101|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 70000021301|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 70000021302|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 70000021303|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 70000021304|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 70000021306|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 70000021401|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 70000021501|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 70000024001|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 70000024401|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013|05/27/2021 70000024502|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 70000025101|CE:CCC-CCCA|Cough and Cold Agents - Clinical|12/15/2015| 70000025901|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 70000026101|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 70000026302|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 70000026401|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 70000027802|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 70000027802|CE:DXO-DEXAA|Dextromethorphan Overutilization|07/16/2012| 70000028701|CE:DXO-DEXAA|Dextromethorphan Overutilization|07/16/2012| 70000028901|CE:DXO-DEXDD|Dextromethorphan Overutilization|07/16/2012| 70000029101|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 70000029201|CE:DUP-NSD|Duplicate Therapy|02/05/2013|03/21/2021 70000029801|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 70000029901|CE:CCC-CCCA|Cough and Cold Agents - Clinical|12/15/2015| 70000029902|CE:CCC-CCCA|Cough and Cold Agents - Clinical|12/15/2015| 70000030101|CE:DXO-DEXQ|Dextromethorphan Overutilization|07/16/2012| 70000030101|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 70000030201|CE:CCC-CCCA|Cough and Cold Agents - Clinical|12/15/2015| 70000030201|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 70000030201|CE:DXO-DEXI|Dextromethorphan Overutilization|07/16/2012| 70000030801|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 70000030802|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 70000031901|CE:DXO-DEXQ|Dextromethorphan Overutilization|07/16/2012| 70000031901|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 70000031902|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 70000031902|CE:DXO-DEXQ|Dextromethorphan Overutilization|07/16/2012| 70000032401|CE:DXO-DEXY|Dextromethorphan Overutilization|07/16/2012| 70000032401|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 70000036001|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 70000036002|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 70000036003|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 70000036101|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 70000036102|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 70000036103|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 70000036104|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 70000036201|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 70000036202|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 70000037201|CE:DXO-DEXW|Dextromethorphan Overutilization|07/16/2012|11/23/2020 70000037201|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015|11/23/2020 70000037202|CE:DXO-DEXW|Dextromethorphan Overutilization|07/16/2012| 70000037202|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 70000038001|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 70000038002|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 70000038003|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 70000038004|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 70000038701|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 70000038701|CE:DXO-DEXQCHLD|Dextromethorphan Overutilization|07/16/2012| 70000038701|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 70000038701|CE:DXO-DEXN|Dextromethorphan Overutilization|07/16/2012| 70000038702|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 70000038702|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 70000038702|CE:DXO-DEXN|Dextromethorphan Overutilization|07/16/2012| 70000038702|CE:DXO-DEXQCHLD|Dextromethorphan Overutilization|07/16/2012| 70000039201|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013|01/30/2021 70000041401|CE:DRO-LPZ15|Drug Regimen Optimization|01/31/2011|12/04/2020 70000041402|CE:DRO-LPZ15|Drug Regimen Optimization|01/31/2011|11/21/2020 70000041403|CE:DRO-LPZ15|Drug Regimen Optimization|01/31/2011|12/13/2020 70000042701|CE:DXO-DEXBB|Dextromethorphan Overutilization|07/16/2012| 70000042702|CE:DXO-DEXBB|Dextromethorphan Overutilization|07/16/2012| 70000045201|CE:CCC-CCCA|Cough and Cold Agents - Clinical|12/15/2015| 70000045202|CE:CCC-CCCA|Cough and Cold Agents - Clinical|12/15/2015| 70000045301|CE:DXO-DEXVCHLD|Dextromethorphan Overutilization|07/16/2012| 70000046701|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 70000047301|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 70000047401|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 70000047402|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 70000047901|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 70000047901|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 70000047902|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 70000047902|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 70000049101|CE:CCC-CCCB|Cough and Cold Agents - Clinical|12/15/2015| 70000049101|CE:DXO-DEXY|Dextromethorphan Overutilization|07/16/2012| 70000049101|CE:CCC-CCCD|Cough and Cold Agents - Clinical|12/15/2015| 70000049201|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 70000050401|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 70000051501|CE:DXO-DEXDD|Dextromethorphan Overutilization|07/16/2012| 70000051601|CE:DXO-DEXBB|Dextromethorphan Overutilization|07/16/2012| 70000051602|CE:DXO-DEXBB|Dextromethorphan Overutilization|07/16/2012| 70000051801|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 70000052701|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 70010001201|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 70010001201|CE:DRO-MPHER10|Drug Regimen Optimization|01/31/2011| 70010001301|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 70010001301|CE:DRO-MPHER20|Drug Regimen Optimization|01/31/2011| 70010001401|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 70010001501|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 70010001603|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 70010004001|CE:ADD-IREVT|ADD/ADHD Agents|12/18/2019| 70010004001|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 70010004101|CE:ADD-IRAMPH|ADD/ADHD Agents|02/13/2014| 70010004101|CE:ADD-IREVT|ADD/ADHD Agents|12/18/2019| 70010075401|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 70010075401|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 70010075405|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 70010075405|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 70010077001|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 70010077001|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 70010077005|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 70010077005|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 70165000530|CE:ADD-ERADZ|ADD/ADHD Agents|01/26/2017| 70165001030|CE:ADD-ERADZ|ADD/ADHD Agents|01/26/2017| 70165001530|CE:ADD-ERADZ|ADD/ADHD Agents|01/26/2017| 70165002030|CE:ADD-ERADZ|ADD/ADHD Agents|01/26/2017| 70165002530|CE:ADD-ERADZ|ADD/ADHD Agents|01/26/2017| 70165003030|CE:ADD-ERADZ|ADD/ADHD Agents|01/26/2017| 70165010030|CE:ADD-ERCOT|ADD/ADHD Agents|09/24/2017| 70165010030|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 70165020030|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 70165020030|CE:ADD-ERCOT|ADD/ADHD Agents|09/24/2017| 70165030030|CE:ADD-ERCOT|ADD/ADHD Agents|09/24/2017| 70165030030|CE:ADD-LAMETHYL|ADD/ADHD Agents|02/13/2014| 70194000330|CE:GIM-TRU|GI Motility|02/06/2018| 70199001401|CE:CYB-CYCLOBEN|Cyclobenzaprine|01/31/2011| 70199001401|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 70199001401|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 70370104001|CE:VMAT-ING|VMAT2 Inhibitors|09/25/2018|02/25/2021 70370108001|CE:VMAT-ING|VMAT2 Inhibitors|09/25/2018| 70370204001|CE:VMAT-ING|VMAT2 Inhibitors|09/25/2018| 70377000112|CE:DRO-SIMVA5|Drug Regimen Optimization|01/31/2011| 70377000112|CE:DUP-STN|Duplicate Therapy|02/04/2016| 70377000114|CE:DUP-STN|Duplicate Therapy|02/04/2016| 70377000114|CE:DRO-SIMVA5|Drug Regimen Optimization|01/31/2011| 70377000115|CE:DUP-STN|Duplicate Therapy|02/04/2016| 70377000115|CE:DRO-SIMVA5|Drug Regimen Optimization|01/31/2011| 70377000212|CE:DRO-SIMVA10|Drug Regimen Optimization|01/31/2011| 70377000212|CE:DUP-STN|Duplicate Therapy|02/04/2016| 70377000214|CE:DUP-STN|Duplicate Therapy|02/04/2016| 70377000214|CE:DRO-SIMVA10|Drug Regimen Optimization|01/31/2011| 70377000215|CE:DUP-STN|Duplicate Therapy|02/04/2016| 70377000215|CE:DRO-SIMVA10|Drug Regimen Optimization|01/31/2011| 70377000312|CE:DRO-SIMVA20|Drug Regimen Optimization|01/31/2011| 70377000312|CE:DUP-STN|Duplicate Therapy|02/04/2016| 70377000314|CE:DUP-STN|Duplicate Therapy|02/04/2016| 70377000314|CE:DRO-SIMVA20|Drug Regimen Optimization|01/31/2011| 70377000315|CE:DUP-STN|Duplicate Therapy|02/04/2016| 70377000315|CE:DRO-SIMVA20|Drug Regimen Optimization|01/31/2011| 70377000412|CE:DRO-SIMVA40|Drug Regimen Optimization|01/31/2011| 70377000412|CE:DUP-STN|Duplicate Therapy|02/04/2016| 70377000414|CE:DUP-STN|Duplicate Therapy|02/04/2016| 70377000414|CE:DRO-SIMVA40|Drug Regimen Optimization|01/31/2011| 70377000415|CE:DRO-SIMVA40|Drug Regimen Optimization|01/31/2011| 70377000415|CE:DUP-STN|Duplicate Therapy|02/04/2016| 70377000512|CE:DUP-STN|Duplicate Therapy|02/04/2016| 70377000514|CE:DUP-STN|Duplicate Therapy|02/04/2016| 70377000515|CE:DUP-STN|Duplicate Therapy|02/04/2016| 70377000612|CE:DUP-STN|Duplicate Therapy|02/04/2016| 70377000612|CE:DRO-ROSUV5|Drug Regimen Optimization|01/31/2011| 70377000613|CE:DRO-ROSUV5|Drug Regimen Optimization|01/31/2011| 70377000613|CE:DUP-STN|Duplicate Therapy|02/04/2016| 70377000712|CE:DUP-STN|Duplicate Therapy|02/04/2016| 70377000712|CE:DRO-ROSUV10|Drug Regimen Optimization|01/31/2011| 70377000713|CE:DRO-ROSUV10|Drug Regimen Optimization|01/31/2011| 70377000713|CE:DUP-STN|Duplicate Therapy|02/04/2016| 70377000812|CE:DUP-STN|Duplicate Therapy|02/04/2016| 70377000812|CE:DRO-ROSUV20|Drug Regimen Optimization|01/31/2011| 70377000813|CE:DRO-ROSUV20|Drug Regimen Optimization|01/31/2011| 70377000813|CE:DUP-STN|Duplicate Therapy|02/04/2016| 70377000911|CE:DUP-STN|Duplicate Therapy|02/04/2016| 70377000912|CE:DUP-STN|Duplicate Therapy|02/04/2016| 70377000913|CE:DUP-STN|Duplicate Therapy|02/04/2016| 70377002711|CE:DRO-ATORV10|Drug Regimen Optimization|01/31/2011| 70377002711|CE:DUP-STN|Duplicate Therapy|02/04/2016| 70377002713|CE:DRO-ATORV10|Drug Regimen Optimization|01/31/2011| 70377002713|CE:DUP-STN|Duplicate Therapy|02/04/2016| 70377002811|CE:DRO-ATORV20|Drug Regimen Optimization|01/31/2011| 70377002811|CE:DUP-STN|Duplicate Therapy|02/04/2016| 70377002813|CE:DUP-STN|Duplicate Therapy|02/04/2016| 70377002813|CE:DRO-ATORV20|Drug Regimen Optimization|01/31/2011| 70377002911|CE:DUP-STN|Duplicate Therapy|02/04/2016| 70377002911|CE:DRO-ATORV40|Drug Regimen Optimization|01/31/2011| 70377002913|CE:DUP-STN|Duplicate Therapy|02/04/2016| 70377002913|CE:DRO-ATORV40|Drug Regimen Optimization|01/31/2011| 70377003012|CE:DUP-STN|Duplicate Therapy|02/04/2016| 70377003014|CE:DUP-STN|Duplicate Therapy|02/04/2016| 70408014634|CE:PRT-PROMETH|Promethazine Utilization|01/31/2011| 70408014634|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 70436000506|CE:DRO-GALANT8|Drug Regimen Optimization|01/31/2011| 70436001002|CE:DRO-BUPR150|Drug Regimen Optimization|01/31/2011| 70436001004|CE:DRO-BUPR150|Drug Regimen Optimization|01/31/2011| 70436001006|CE:DRO-BUPR150|Drug Regimen Optimization|01/31/2011| 70436009006|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 70436009106|CE:LTMC-MON|Leukotriene Modifiers - Clinical|12/15/2015| 70515071101|CE:DUP-CRTROD|Duplicate Therapy|02/05/2013| 70515071201|CE:DUP-CRTROD|Duplicate Therapy|02/05/2013| 70709000060|CE:ENZ-NOR|Enzymes|11/20/2019| 70709000260|CE:ENZ-NOR|Enzymes|11/20/2019| 70709000560|CE:ENZ-NOR|Enzymes|11/20/2019| 70710111000|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 70710111001|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 70710112901|CE:APY-FGA|Antipsychotics|04/10/2016| 70710113001|CE:APY-FGA|Antipsychotics|04/10/2016| 70710113101|CE:APY-FGA|Antipsychotics|04/10/2016| 70710113201|CE:APY-FGA|Antipsychotics|04/10/2016| 70710113301|CE:APY-FGA|Antipsychotics|04/10/2016| 70710116701|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 70710116801|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 70710134401|CE:ASH-RAMELT|Anxiolytics Sedatives and Hypnotics|01/31/2011| 70710134403|CE:ASH-RAMELT|Anxiolytics Sedatives and Hypnotics|01/31/2011| 70710151406|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 70710151409|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 70710151506|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 70710151509|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 70710151606|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 70710151609|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 70710151706|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 70710151709|CE:DUP-ANTCAG|Duplicate Therapy|02/05/2013| 70748021507|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 70748021607|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 70752010112|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 70756070360|CE:RAN-RAN|Ranolazine|05/25/2012| 70756070460|CE:RAN-RAN|Ranolazine|05/25/2012| 70756080630|CE:DRO-LPZ15|Drug Regimen Optimization|01/31/2011| 70756080830|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 70756080930|CE:DRO-OLMES20|Drug Regimen Optimization|01/31/2011| 70756080930|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 70756080990|CE:DRO-OLMES20|Drug Regimen Optimization|01/31/2011| 70756080990|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 70756081030|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 70756081090|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 70756081230|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 70756081230|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 70756081290|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 70756081290|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 70756081330|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 70756081330|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 70756081390|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 70756081390|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 70756081430|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 70756081430|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 70756081490|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 70756081490|CE:DUP-ARB|Duplicate Therapy|02/05/2013| 70839011230|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 70839011230|CE:ASN-ALISK150|Aliskiren-Containing Agents|07/16/2012| 70839012530|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 70839012530|CE:ASN-ALISK150|Aliskiren-Containing Agents|07/16/2012| 70839015030|CE:ASN-ALISK150|Aliskiren-Containing Agents|07/16/2012| 70839030030|CE:ASN-ALISK300|Aliskiren-Containing Agents|07/16/2012| 70839031230|CE:ASN-ALISK300|Aliskiren-Containing Agents|07/16/2012| 70839031230|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 70839032530|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 70839032530|CE:ASN-ALISK300|Aliskiren-Containing Agents|07/16/2012| 70868075016|CE:CCC-CCCA|Cough and Cold Agents - Clinical|12/15/2015| 70868075016|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 70954001410|CE:APY-FGA|Antipsychotics|04/10/2016| 70954001510|CE:APY-FGA|Antipsychotics|04/10/2016| 70954001610|CE:APY-FGA|Antipsychotics|04/10/2016| 70954001710|CE:APY-FGA|Antipsychotics|04/10/2016| 70954005710|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 70954005710|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 70954005810|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 70954005810|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 70954005820|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 70954005820|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 70954005830|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 70954005830|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 70954005840|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 70954005840|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 70954005910|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 70954005910|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 70954005920|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 70954005920|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 70954005930|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 70954005930|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 70954005940|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 70954005940|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 70954006010|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 70954006010|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 70954006020|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 70954006020|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 70954006030|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 70954006030|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 70954006110|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 70954006110|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 70954008510|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 70954008510|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 70954008520|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 70954008520|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 70954016810|CE:SDF-REVSUSP|Sildenafil (Revatio)|09/01/2015| 71093011104|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 71093011105|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 71093011204|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 71093011205|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 71093012004|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 71093012005|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 71093012104|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 71093012105|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 71093012204|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 71093012205|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 71093013602|CE:APY-SGA|Antipsychotics|04/10/2016| 71093013702|CE:APY-SGA|Antipsychotics|04/10/2016| 71093013802|CE:APY-SGA|Antipsychotics|04/10/2016| 71093013902|CE:APY-SGA|Antipsychotics|04/10/2016| 71225010401|CE:MAK-MAK|Makena|06/12/2015| 71225010501|CE:MAK-MAK|Makena|06/12/2015| 71376020103|CE:ADD-ERCOT|ADD/ADHD Agents|09/24/2017| 71376020203|CE:ADD-ERCOT|ADD/ADHD Agents|09/24/2017| 71376020303|CE:ADD-ERCOT|ADD/ADHD Agents|09/24/2017| 71376020403|CE:ADD-ERCOT|ADD/ADHD Agents|09/24/2017| 71376020503|CE:ADD-ERCOT|ADD/ADHD Agents|09/24/2017| 71930001912|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930001912|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 71930001912|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930001912|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 71930001952|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 71930001952|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930001952|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 71930001952|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930002012|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930002012|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 71930002012|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 71930002012|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930002052|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930002052|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 71930002052|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 71930002052|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930002112|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 71930002112|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930002112|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 71930002112|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930002152|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930002152|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 71930002152|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 71930002152|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930002243|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 71930002243|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930002243|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 71930002243|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930002330|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930002330|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 71930002330|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930002452|CE:ADD-IRMETHYL|ADD/ADHD Agents|02/13/2014| 71930002552|CE:ADD-IRMETHYL|ADD/ADHD Agents|02/13/2014| 71930002743|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930002743|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930002743|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 71930002743|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 71930004212|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 71930004212|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 71930004212|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930004212|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930004252|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930004252|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 71930004252|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930004252|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 71930004312|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930004312|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 71930004312|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930004312|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 71930004352|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930004352|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 71930004352|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930004352|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 71930004412|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 71930004412|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930004412|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930004412|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 71930004452|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 71930004452|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930004452|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 71930004452|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930004512|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 71930004512|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930004512|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 71930004512|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930004552|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930004552|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930004552|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 71930004552|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 71930004612|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930004612|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 71930004612|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 71930004612|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930004652|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930004652|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 71930004652|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 71930004652|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930004712|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930004712|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 71930004712|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 71930004712|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930004752|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 71930004752|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930004752|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 71930004752|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930005412|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930005412|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 71930005412|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 71930005412|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930005452|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930005452|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930005452|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 71930005452|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 71930005512|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 71930005512|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 71930005512|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930005512|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930005552|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 71930005552|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 71930005552|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930005552|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930005612|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930005612|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 71930005612|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930005612|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 71930005652|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 71930005652|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930005652|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 71930005652|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 72060014230|CE:APY-SGA|Antipsychotics|04/10/2016| 72205000290|CE:DRO-ROSUV5|Drug Regimen Optimization|01/31/2011|01/31/2022 72205000290|CE:DUP-STN|Duplicate Therapy|02/04/2016|01/31/2022 72205000299|CE:DRO-ROSUV5|Drug Regimen Optimization|01/31/2011|01/31/2022 72205000299|CE:DUP-STN|Duplicate Therapy|02/04/2016|01/31/2022 72205000390|CE:DUP-STN|Duplicate Therapy|02/04/2016| 72205000390|CE:DRO-ROSUV10|Drug Regimen Optimization|01/31/2011| 72205000399|CE:DUP-STN|Duplicate Therapy|02/04/2016| 72205000399|CE:DRO-ROSUV10|Drug Regimen Optimization|01/31/2011| 72205000490|CE:DRO-ROSUV20|Drug Regimen Optimization|01/31/2011| 72205000490|CE:DUP-STN|Duplicate Therapy|02/04/2016| 72205000499|CE:DRO-ROSUV20|Drug Regimen Optimization|01/31/2011| 72205000499|CE:DUP-STN|Duplicate Therapy|02/04/2016| 72205000530|CE:DUP-STN|Duplicate Therapy|02/04/2016| 72205000590|CE:DUP-STN|Duplicate Therapy|02/04/2016| 72205000599|CE:DUP-STN|Duplicate Therapy|02/04/2016| 72205002030|CE:DRO-SOLAF5|Drug Regimen Optimization|01/31/2011| 72205002090|CE:DRO-SOLAF5|Drug Regimen Optimization|01/31/2011| 72205002205|CE:DUP-STN|Duplicate Therapy|02/04/2016| 72205002205|CE:DRO-ATORV10|Drug Regimen Optimization|01/31/2011| 72205002305|CE:DRO-ATORV20|Drug Regimen Optimization|01/31/2011| 72205002305|CE:DUP-STN|Duplicate Therapy|02/04/2016| 72205002405|CE:DRO-ATORV40|Drug Regimen Optimization|01/31/2011| 72205002405|CE:DUP-STN|Duplicate Therapy|02/04/2016| 72205002505|CE:DUP-STN|Duplicate Therapy|02/04/2016| 72205002790|CE:DUP-STN|Duplicate Therapy|02/04/2016| 72205002790|CE:DRO-ROSUV5|Drug Regimen Optimization|01/31/2011| 72205002799|CE:DRO-ROSUV5|Drug Regimen Optimization|01/31/2011| 72205002799|CE:DUP-STN|Duplicate Therapy|02/04/2016| 72245019303|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 72245019303|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 72245019303|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 72245019303|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 72245019310|CE:OPO-OOVU|Opiate Overutilization|11/05/2013| 72245019310|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 72245019310|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 72245019310|CE:OPC-MEDS|Opioid Policy Criteria|09/01/2020| 72485010125|CE:DUP-ANTHIS|Duplicate Therapy|02/05/2013| 72495020105|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 72495020210|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 72511075001|CE:PCS-REP|PCSK9 Inhibitors|01/04/2017| 72511076002|CE:PCS-REP|PCSK9 Inhibitors|01/04/2017| 72511077001|CE:PCS-REP|PCSK9 Inhibitors|01/04/2017| 72578006414|CE:RAN-RAN|Ranolazine|05/25/2012| 72578006514|CE:RAN-RAN|Ranolazine|05/25/2012| 72606000901|CE:DRO-SOLAF5|Drug Regimen Optimization|01/31/2011| 72606000902|CE:DRO-SOLAF5|Drug Regimen Optimization|01/31/2011| 72626260101|CE:HCA-HEPC|Hepatitis C Agents Clinical|01/23/2015| 72626270101|CE:HCA-HEPC|Hepatitis C Agents Clinical|01/23/2015| 72647033101|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 72647033101|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 72647033104|CE:DUP-OCRT|Duplicate Therapy|02/05/2013| 72647033104|CE:DUP-OCS|Duplicate Therapy|02/04/2016| 72733590102|CE:PCS-PRA|PCSK9 Inhibitors|01/04/2017| 72733590202|CE:PCS-PRA|PCSK9 Inhibitors|01/04/2017| 72786010101|CE:SCA-SCA|Sickle Cell Agents|09/08/2020| 72912052530|CE:ADD-ERCOT|ADD/ADHD Agents|09/24/2017| 72912053530|CE:ADD-ERCOT|ADD/ADHD Agents|09/24/2017| 72912054530|CE:ADD-ERCOT|ADD/ADHD Agents|09/24/2017| 72912055530|CE:ADD-ERCOT|ADD/ADHD Agents|09/24/2017| 72912057030|CE:ADD-ERCOT|ADD/ADHD Agents|09/24/2017| 72912058530|CE:ADD-ERCOT|ADD/ADHD Agents|09/24/2017| 75834012929|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 75834013029|CE:DUP-HRT|Duplicate Therapy|02/05/2013| 75834020501|CE:DUP-MGL|Duplicate Therapy|02/05/2013| 75834020601|CE:DUP-MGL|Duplicate Therapy|02/05/2013| 75834021730|CE:DRO-VENL75|Drug Regimen Optimization|01/31/2011| 75834021790|CE:DRO-VENL75|Drug Regimen Optimization|01/31/2011| 75987001003|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 75987003004|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 75987003104|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 75987004005|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 76204020001|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 76204020025|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 76204020030|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 76204020060|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 76204060005|CE:DUP-LABAC|Duplicate Therapy|02/04/2016| 76204060012|CE:DUP-LABAC|Duplicate Therapy|02/04/2016| 76204060030|CE:DUP-LABAC|Duplicate Therapy|02/04/2016| 76204060060|CE:DUP-LABAC|Duplicate Therapy|02/04/2016| 76204070001|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 76204070025|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 76204080001|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 76204080025|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 76204090001|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 76204090025|CE:DUP-SABA|Duplicate Therapy|02/05/2013| 76282015201|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 76282015201|CE:COX-MOBIC|COX-2 Inhibitors|01/31/2011| 76282015201|CE:DRO-MELOX7.5|Drug Regimen Optimization|01/31/2011| 76282015210|CE:DRO-MELOX7.5|Drug Regimen Optimization|01/31/2011| 76282015210|CE:COX-MOBIC|COX-2 Inhibitors|01/31/2011| 76282015210|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 76282015301|CE:COX-MOBIC|COX-2 Inhibitors|01/31/2011| 76282015301|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 76282015310|CE:DUP-COXC|Duplicate Therapy|02/04/2016| 76282015310|CE:COX-MOBIC|COX-2 Inhibitors|01/31/2011| 76282020010|CE:DRO-FOSI10|Drug Regimen Optimization|01/31/2011| 76282020090|CE:DRO-FOSI10|Drug Regimen Optimization|01/31/2011| 76282020110|CE:DRO-FOSI20|Drug Regimen Optimization|01/31/2011| 76282020190|CE:DRO-FOSI20|Drug Regimen Optimization|01/31/2011| 76282021201|CE:DRO-SRL25|Drug Regimen Optimization|01/31/2011| 76282021205|CE:DRO-SRL25|Drug Regimen Optimization|01/31/2011| 76282021301|CE:DRO-SRL50|Drug Regimen Optimization|01/31/2011| 76282021305|CE:DRO-SRL50|Drug Regimen Optimization|01/31/2011| 76282021330|CE:DRO-SRL50|Drug Regimen Optimization|01/31/2011| 76282023710|CE:DRO-AMLOD2.5|Drug Regimen Optimization|01/31/2011| 76282023790|CE:DRO-AMLOD2.5|Drug Regimen Optimization|01/31/2011| 76282023810|CE:DRO-AMLOD5|Drug Regimen Optimization|01/31/2011| 76282023890|CE:DRO-AMLOD5|Drug Regimen Optimization|01/31/2011| 76282024910|CE:DRO-ETP5|Drug Regimen Optimization|01/31/2011| 76282024930|CE:DRO-ETP5|Drug Regimen Optimization|01/31/2011| 76282024990|CE:DRO-ETP5|Drug Regimen Optimization|01/31/2011| 76282025010|CE:DRO-ETP10|Drug Regimen Optimization|01/31/2011| 76282025090|CE:DRO-ETP10|Drug Regimen Optimization|01/31/2011| 76282025701|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 76282025801|CE:DUP-NSD|Duplicate Therapy|02/05/2013| 76282037702|CE:FOS-FOSRENOL|Fosrenol (Lanthanum Carbonate)|01/31/2011| 76282040501|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 76282040505|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 76282040590|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 76282040601|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 76282040605|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 76282040690|CE:GAB-GABA|Anticonvulsant Agents (Gabapentin)|01/31/2011| 76282044601|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 76282044605|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 76282044610|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 76282044690|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 76282044701|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 76282044705|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 76282044710|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 76282044790|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 76282044801|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 76282044805|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 76282044810|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 76282044890|CE:DUP-TZDTS|Duplicate Therapy|02/05/2013| 76282064038|CE:DUP-CRTROD|Duplicate Therapy|02/05/2013| 76282064138|CE:DUP-CRTROD|Duplicate Therapy|02/05/2013| 76385012301|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 76385012301|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 76385012350|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 76385012350|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 76385012401|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 76385012401|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 76385012450|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 76385012450|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017| 76439030210|CE:NTR-BMR|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|04/14/2021 76439030210|CE:NTR-OBM|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|04/14/2021 76439030210|CE:NTR-OBE|New Trilogy Edit (opiates/benzos/muscle relaxants)|03/26/2017|04/14/2021 99207027028|CE:IMI-IMIQ|Imiquimod|07/16/2012|