UnitedHealthcare
Ultresa 20,700-41,400 Unit Cpdr (lipase-protease-amylase)
Drugs for the Stomach : Drugs for the Stomach
  • Step Therapy: Pancreatic Insufficiency: Pancreatic Enzymes:
    ST Single Brand

  • Pancreatic Insufficiency: Pancreatic Enzymes:
    Medical Test Required: No
    Reauthorization Required: No
    Documented Diagnosis: No

  • Prior Authorization: Pancreatic Insufficiency: Pancreatic Enzymes:
    PA Applies

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