UnitedHealthcare - 2014 to Present
ZTlido (lidocaine)
Drugs for the Skin : Drugs for the Skin
  • Quantity Limit: 204 lancets per 30 day(s).
  • Step Therapy: Ankylosing Spondylitis (AS), Crohn's Disease (CD), Psoriasis (PsO), Psoriatic Arthritis (PsA), Rheumatoid Arthritis (RA):
    ST Multiple Brands

    Nonradiographic Axial Spondyloarthritis:
    ST Multiple Generics

  • Quantity Limit: 4 tablets per 1 day(s).
<< Return | Back to top