To learn about SoonerCare's citizenship requirements, view our eligibility guidelines. Para obtener más información sobre los requisitos de ciudadanía de SoonerCare, consulte nuestras pautas de elegibilidad.

Special Formulations

Millipred
Veripred

prednisolone oral solution (Millipred®, Veripred 20®)
PA criteria: Veripred™ 20 (Prednisolone Sodium Phosphate Oral Solution 20mg/5mL) and Millipred™ (Prednisolone Sodium Phosphate Oral Solution 10mg/5mL) Approval Criteria: Authorization of Veripred™ 20 or Millipred™ requires a patient-specific, clinically significant reason why the member cannot use a tablet or an alternative strength liquid formulation. Prior Authorization form

prednisolone oral solution (Millipred®, Veripred 20®)

PA criteria:

Veripred™ 20 (Prednisolone Sodium Phosphate Oral Solution 20mg/5mL) and Millipred™ (Prednisolone Sodium Phosphate Oral Solution 10mg/5mL) Approval Criteria:

Authorization of Veripred™ 20 or Millipred™ requires a patient-specific, clinically significant reason why the member cannot use a tablet or an alternative strength liquid formulation.

Prior Authorization form

Last Modified on Nov 10, 2020