| Specialty Exceptions Autoimmune ACSF BAL PDPD VF 3246 D P2020a |
| Specialty Exceptions Autoimmune ACSF BAL PDPD VF 3246 D P2020a |
| Specialty Exceptions Autoimmune ACSF BAL PDPD VF 3246 D P2020a |
| Specialty Exceptions Autoimmune ACSF BAL PDPD VF 3246 D P2020a |
| Specialty Exceptions Autoimmune ACSF BAL PDPD VF 3246 D P2020a |
| Specialty Exceptions Autoimmune ACSF BAL PDPD VF 3246 D P2020a |
| Specialty Exceptions Autoimmune ACSF BAL PDPD VF 3246 D P2020a |
| Specialty Exceptions Autoimmune ACSF BAL PDPD VF 3246 D P2020a |
| Specialty Exceptions Autoimmune ACSF BAL PDPD VF 3246 D P2020a |
| Specialty Exceptions Autoimmune ACSF BAL PDPD VF 3246 D P2020a |
| Specialty Exceptions Autoimmune ACSF BAL PDPD VF 3246 D P2020a |
| Specialty Exceptions Autoimmune ACSF PDPD VF 2718 D P2019a |
| Specialty Exceptions Autoimmune ACSF PDPD VF 2718 D P2019b |
| Specialty Quantity Limit Actemra P2018a |
| Specialty Quantity Limit Cimzia 2267 H P2019 |
| Specialty Quantity Limit Cosentyx 1737 H P2019 |
| Specialty Quantity Limit Crysvita P2018 |
| Specialty Quantity Limit Enbrel 2268 H P2019a |
| Specialty Quantity Limit Ilumya 2543 H P2019 |
| Specialty Quantity Limit Olumiant 2602 H P2019a |
