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Anthem Blue Cross : Access to Non-Drug List/ Formulary Medication

Access to Non-Drug List/ Formulary Medication

PW_E169308
The Drug Utilization Review (DUR) exception process provides access to most non-drug list/formulary medications, multi- source brands, therapeutic interchanges and step therapy procedures. When the prescribing physician denotes "do not substitute" (DNS) or "dispense as written" (DAW) on the prescription, the pharmacist transmits the claim using the appropriate DUR code to allow adjudication of the claim. Select non-drug list/formulary medications are channeled through the Prior Authorization of Benefits process where an internal review is required prior to dispensing.  

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Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company are independent licensees of the Blue Cross Association.