Introduction to Clinical Criteria 

Table 1 : Immune Globulins

Table 2 : Hormones - Gonadotropin-Releasing Hormone Analogs

Table 3 : Gastrointestinal Drugs - Histamine H2 Antagonists, Proton Pump Inhibitors, and Miscellaneous Gastroesophageal Reflux Agents

Table 4 : Hematologic Agents - Hematopoietic and Miscellaneous Hematologic Agents

Table 5 : Immunological Agents

Table 6 : Nutrients, Vitamins, and Vitamin Analogs

Table 7 : Muscle Relaxants - Skeletal

Table 8 : Opioids and Analgesics

Table 9 : Growth Hormones and Increlex

Table 10 : Dermatologic Agents - Acne and Rosacea

Table 11 : Nonsteroidal Anti-Inflammatory Drugs

Table 12 : Antihistamines

Table 13 : Lipid-Lowering Agents

Table 14 : Headache Therapy

Table 15 : Hypnotics

Table 16 : Corticosteroids - Topical

Table 17 : Antidepressants

Table 18 : Cardiovascular Agents

Table 19 : Benign Prostatic Hyperplasia (BPH) Agents

Table 20 : Anticonvulsants

Table 21 : Cystic Fibrosis Agents

Table 22 : Acromegaly Agents and Carcinoid Syndrome Agents

Table 23 : Respiratory Agents - Inhaled

Table 24 : Antipsychotics

Table 25 : Corticosteroids - Intranasal

Table 26 : Antidiabetic Agents - Oral

Table 27 : Antiemetics, Appetite Stimulants, and Anabolics

Table 28 : Antifungal Agents - Topical

Table 29 : Anti-Allergy and Anti-Inflammatory Agents - Ophthalmic

Table 30 : Neuromuscular Blocker Agents

Table 31 : Cerebral Stimulants and Miscellaneous Agents

Table 32 : Serums, Toxoids, and Vaccines

Table 33 : Inflammatory Bowel Disease Agents

Table 34 : Antibiotics - Ophthalmic

Table 35 : Antibiotics and Anti-Infectives - Oral

Table 36 : Drug and Alcohol Cessation Agents

Table 37 : Palivizumab (Synagis)

Table 38 : Antiretroviral/HIV Therapy

Table 39 : Neuraminidase Inhibitors

Table 40 : Respiratory Agents - Oral

Table 41 : Antibiotics - Topical

Table 42 : Immune Suppressants - Topical

Table 43 : Pulmonary Arterial Hypertension Agents

Table 44 : Hepatitis Antiviral Agents

Table 45 : Antidiabetic Agents - Injectable and Insulin

Table 46 : Urinary Dysfunction Agents

Table 47 : Antifungal Agents - Oral and Injectable

Table 48 : Antiparkinsonian Agents

Table 49 : Osteoporosis and Bone Metabolism Agents

Table 50 : Modafinil Agents

Table 51 : Antiglaucoma Agents - Ophthalmic

Table 52 : Multiple Sclerosis Agents

Table 53 : Antibiotics - Otic

Table 54 : Pediculicides and Scabicides

Table 55 : Androgens

Table 56 : Alzheimer’s Agents

Table 57 : Oncology Agents

Table 58 : Anticoagulants and Antiplatelet Agents

Table 59 : Anesthetics - Topical

Table 60 : Hereditary Angioedema Agents

Table 61 : Gastrointestinal Drugs – Antidiarrheals, Constipation, and Miscellaneous Gastrointestinal Agents

Table 62 : Anti-Gout Agents

Table 63 : Dermatologic Agents - Topical Chemotherapy, Genital Wart Treatment, and Miscellaneous Dermatologic Agents

Table 64 : Asthma/Allergy Monoclonal Antibodies

Table 65 : Enzyme Replacement and Substrate Reduction Therapies

Table 66 : Antibiotics – Injectable

Table 67 : Antiviral Agents

Table 68 : Immune Thrombocytopenia (ITP) Agents

Table 69 : Barbiturates, Benzodiazepines, and Miscellaneous Anti-Anxiety Agents

Table 70 : Progesterone Agents

Table 71 : Pediatric Behavioral Health

Table 72 : Agents Not Otherwise Classified

Table 73 : Iron Agents and Chelators

Table 74 : Vesicular Monoamine Transporter 2 (VMAT2) Inhibitors

Table 75 : Chimeric Antigen Receptor (CAR)-T Immunotherapies

Table 76 : Neuromuscular Agents – Duchenne Muscular Dystrophy and Spinal Muscular Atrophy

Table 77 : Hyaluronan Injections