| Anthem Blue Cross (HMO, PPO, EPO) |
| Avonex (Pnij) (interferon beta-1a) |
| Drugs for the Nervous System : Drugs for Multiple Sclerosis |
- Multiple Sclerosis (MS):
Duration: 1 year(s)
Documented Diagnosis: Yes
Medical Test Required: No
Reauthorization Required: No
Duration of Reauthorization: N/A
Patients Cardiac Medical History Required: No
Concomitant use of other MS medication: No
- Prior Authorization: Multiple Sclerosis (MS):
Documented Diagnosis: Yes
Duration: 1 year(s)
|