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Product Name Implementation Date Guideline
ULORICŪ 07/20/09 Uloric may be subject to step therapy requirements. Patients must have a trial and failure of allopurinol 300mg.
ULTRACETŪ 04/01/07 The limits are 8 tablets per day.
ULTRAM ERŪ 02/15/06 The limits are 1 tablet per day.
ULTRAMŪ 09/04/02 The limits are 8 tablets per day.
UPTRAVIŪ 01/20/16 Prior authorization for medical necessity is required. The quantity limits are 60 tabs per 30 days and 1 titration pack per 180 days.
UTIBRON NEOHALER 11/19/15 The limits are 60 capsules per 30 days.