Prior Authorization Programs for Members on the Performance Select Biosimilar Drug List
List of drug categories and specific drugs assigned to Performance Select Biosimilar Drug List prior authorization programs, showing mapping/groupings (multiple numbered tiers) and alternative dosage form notes. This part contains a fragmented enumerated mapping of categories to specific products.
This document is a mapping/list of categories to specific drugs for the Performance Select Biosimilar Drug List.
This file (part 2 of 3) lists numerous drugs, therapeutic categories, and mappings (e.g., branded to biosimilar/alternative) relevant to the Performance Select Biosimilar Drug List prior authorization program.
Part 3 provides additional drug name mappings and category examples included in the Performance Select Biosimilar Drug List.
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