UnitedHealthcare - 2014 to Present |
Xartemis XR (oxycodone-acetaminophen) |
Drugs for Pain and Fever : Arthritis and Pain Drugs |
- Quantity Limit: limit maximum 0.60 EA PER 1 day(s)
- Prior Authorization: Myelodysplastic Syndrome:
Documented Diagnosis: Yes
Duration: 12 Month(s)
- May be covered under Medical Benefit.
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