Health Net
Caverject Impulse (alprostadil)
Drugs for the Urinary System : Drugs for Erectile Dysfunction
  • Prior Authorization: Erectile Dysfunction (ED):
    Documented Diagnosis: Yes
    Age Requirement: >= 18
    Gender Requirement: Male
    Duration: 6 Month(s)
    Reauthorization Required: Yes

  • Step Therapy: Erectile Dysfunction (ED):
    ST Single Generic

  • Erectile Dysfunction (ED):
    Age Requirement: >= 18
    Duration: 6 Month(s)
    Gender Requirement: Male
    Documented Diagnosis: Yes
    Medical Test Required: No
    Reauthorization Required: Yes
    Duration of Reauthorization: >= 6 month(s)

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