Clinical Pharmacy Program Guidelines for Repatha
low-intensity statin [i.e. simvastatin 10 mg, pravastatin 10-20 mg, lovastatin 20 mg, fluvastatin 20-40 mg, or Livalo ... Patient has a history of contraindication or intolerance to ezetimibe -AND- (4) Used as an adjunct to a low-fat diet and exercise ... (ICD-10) and/or claim logic. Use of automated approval and re-approval processes ................
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