UnitedHealthcare
Xolair (omalizumab)
Drugs for the Lungs : Drugs for Asthma/COPD
  • Nasal Polyposis:
    Duration: 12 Month(s)
    Specialist Required: Yes
    Documented Diagnosis: Yes
    Medical Test Required: No
    Specialist Type(s): 1 of Allergist;Immunologist;Otolaryngologist (Ear, Nose, and Throat Specialist);Pulmonologist
    Reauthorization Required: Yes
    Duration of Reauthorization: = 12 month(s)

  • Step Therapy: Nasal Polyposis:
    ST Single Generic

  • Prior Authorization: Nasal Polyposis:
    Documented Diagnosis: Yes
    Duration: 12 Month(s)
    Reauthorization Required: Yes

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