Quantity Limits

Quantity limitations are in place for the drugs listed below. When a drug has a quantity limit, the amount of medication per prescription is limited to a specified amount per 30 days. These limitations may be in place due to safety issues or because the use of a dose higher than what is recommended has been shown to result in minimal additional benefit to the patient.  Requests for increased quantities are only approved when the guidelines below are met.  Quantity limit guidelines are developed and approved by a panel of practicing physicians and pharmacists. 

Click on the drug name below to view the specific quantity limit guideline.

Commercial & Medicare Guidelines:
Actiq_Fentora QL
Ampyra QL
Antidepressant QL
Antiemetics QL
Avodart QL
Celebrex QL
ED Agents QL
Fentora_Onsolis QL 
HMG QL
Intuniv QL
Long Acting Opioid Agonist Agents QL
LMWH QL
Lysteda QL
NSA QL
Oxycontin QL
PPI QL
Relenza_Tamiflu QL
Savella QL
Strattera QL
Triptans QL
Vimovo ST_QL
Vyvanse QL
Xarelto QL
Zipsor ST and QL

Commercial -Only Guidelines:
Nucynta_Nucynta ER QL (Commercial Only)
Suboxone QL (Commercial Only)

Medicare-Only Guidelines:
Antiemetics QL
Nucynta QL (Medicare Only)
Provigil QL (Medicare Only)
Short Acting Opioids QL
Short Acting Opioid Combo Products QL