Sharp Health Plan - All plan years
Sernivo (betamethasone dipropionate)
Drugs for the Skin : Drugs for the Skin
  • Prior Authorization: Breast Cancer: PIK3CA:
    Documented Diagnosis: Yes
    Medical Test Required: Yes
    Duration: 1 year(s)

  • Quantity Limit: limit maximum 60 EA PER 30 day(s)