Maximum Dosage and Frequency (for Ohio Only) – Community Plan Medical Benefit Drug Policyopen_in_new
Defines maximum dosage per administration and dosing frequency (HCPCS units and NDC quantities) for numerous provider-administered medications in Ohio, and states that doses beyond labeled or evidence-supported maxima are unproven and not medically necessary.
Revised list of applicable drug products to add denosumab-bmwo (Stoboclo & Osenvelt).
Revised list of applicable drug products to add denosumab-bnht (Bomyntra & Conexxence) and denosumab-nxxp (Bildyos & Bilprevda).
Revised list of applicable drug products to add eculizumab-aagh (Epysqli) and eculizumab-aeeb (Bkemv).
Revised list of applicable drug products to add ustekinumab-srlf (Imuldosa).
Added maximum allowed quantities by HCPCS units for multiple newly listed products including Bildyos, Bilprevda, Bkemv, Bomyntra, Conexxence, Epysqli, Imuldosa, Osenvelt, and Stoboclo.
Added maximum allowed quantities for National Drug Code (NDC) billing for the newly listed products with specific NDCs.
Added maximum allowed frequencies for Bildyos (denosumab-nxxp) and Bilprevda (denosumab-nxxp).
Updated References section and archived previous policy version CSOH2025D0034.J.
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