- Neuromyelitis Optica Spectrum Disorder:
Duration: 12 Month(s)
Specialist Required: Yes
Documented Diagnosis: Yes
Medical Test Required: Yes
Specialist Type(s): Neurologist
Reauthorization Required: Yes
Duration of Reauthorization: = 12 month(s)
- Prior Authorization: Neuromyelitis Optica Spectrum Disorder:
Documented Diagnosis: Yes
Medical Test Required: Yes
Duration: 12 Month(s)
Reauthorization Required: Yes
- Step Therapy: Neuromyelitis Optica Spectrum Disorder:
ST Single Brand
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