Xylon≥nericName=hydrocodone-ibuprofen∨gName=Oscar Health - 2018 to Present ()
Drugs for Pain and Fever⊂class=Arthritis and Pain Drugs : 
  • PA_APPLIES
  • Quantity Limit: 1 tube per 1 day(s).
  • Step Therapy: Low Testosterone:
    Step Applies
  • Derm: Onchomycosis:
    Duration: 48 week(s)
    Medical Test Required: Yes
    Reauthorization Required: No
    Duration of Reauthorization: N/A
    Treatment for non-cosmetic purposes: Yes
    Documented Size of Fungal Infection: N/A
    Documented Trial and Failure Length of Generic Penlac: >= 12 week(s)
    Patient Must Not Also Be Using With an Oral Antifungal Agent: No
    Re-approval not allowed: No
    Supporting Documentation Requirements: 3 of Chart Notes;Medical Tests;Medication History
    Documented Diagnosis: Yes
    Size of fungal infection <= 50% involvement: No
    Patient must have documented failure of at least 48 weeks of generic Penlac: No
    Concomitant drug therapy not allowed: No