| Anthem Blue Cross - 2014 to Present (HMO, PPO, EPO) |
| Skyrizi (Syrg) (risankizumab-rzaa) |
| Drugs for the Skin : Drugs for the Skin |
- Prior Authorization: Diabetes Type 2: DPP4 + Combo:
Documented Diagnosis: Yes
Medical Test Required: Yes
Age Requirement: >= 18
Duration: 1 plan year
Reauthorization Required: Yes
- Anti-Cancer:Maximum $200 copayment per State Law.
- Step Therapy: Antiviral: Hepatitis C (HCV):
ST Multiple Generics
|