| UnitedHealthcare |
| Fabrazyme (agalsidase beta) |
| Drugs for Metabolic Disease : Drugs for Metabolic Disease |
- Prior Authorization: Fabry's Disease:
Documented Diagnosis: Yes
Duration: 60 Month(s)
- Fabry's Disease:
Duration: 60 Month(s)
Documented Diagnosis: Yes
Medical Test Required: No
Reauthorization Required: No
Duration of Reauthorization: N/A
|