| Anthem Blue Cross - 2014 to Present (HMO, PPO, EPO) |
| Mitigare (colchicine) |
| Drugs for Pain and Fever : Gout Drugs |
- ST_APPLIES
- Derm: Acne Vulgaris:
Age Requirement: >= 12
Duration: 1 plan year
Documented Diagnosis: Yes
Medical Test Required: No
Reauthorization Required: Yes
Duration of Reauthorization: = 1 plan year
Limited to non-cosmetic use: No
Supporting Documentation Requirements: Chart Notes
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