Transcription of Quantity Limit Program Drug List - BCBSM
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Quantity Limit Program Drug List - BCBSM
Quantity Limit Program May 2022 * Limited to a 15 day supply ** Limited to a 30 day supply Page 1 Revised: 05-01-22 Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. The Quantity Limit Program encourages safe medication use. The chart below lists Quantity limits for medications on Blue Cross Blue Shield of Michigan s Clinical, Closed, Custom and Custom Select drug Lists, Blue Cross and Blue Care Network s Preferred drug List and Blue Care Network s Closed, Custom and Custom Select drug Lists.
The quantities are consistent with the Food and Drug Administration’s approved dosing guidelines. ... Abilify MyCite = brand name (aripiprazole) = generic name Quantity limits for: Medication BCBSM Clinical ,CustomClosed Drug Lists ... (imiquimod) 1 packet per day 1 packet per day 1 packet per day 1 packet per day 1 packet per day
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