- Prior Authorization: Spinal Muscular Atrophy (SMA):
Documented Diagnosis: Yes
Medical Test Required: Yes
Age Requirement: <= 2
Duration: 4 week(s)
- Spinal Muscular Atrophy (SMA):
Age Requirement: <= 2
Duration: 4 week(s)
Specialist Required: Yes
Documented Diagnosis: Yes
Medical Test Required: Yes
Specialist Type(s): Neurologist
Reauthorization Required: No
Duration of Reauthorization: N/A
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