| HealthNet - All plan years |
| Otezla Starter 10 Mg (4)-20 Mg (4)-30 Mg(19) DsPk (apremilast) |
| Drugs for the Skin : Drugs for the Skin |
- Prior Authorization: PA_APPLIES
- PA Applies
- Quantity Limit: 5 tablets per 1 day(s).
- Step Therapy: Neuromyelitis Optica Spectrum Disorder:
ST Single Brand
- Zero Copay;
- Quantity Limit: limit maximum 1 EA PER 1 day(s)
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