| HealthNet - All plan years |
| Siliq (brodalumab) |
| Drugs for the Skin : Drugs for the Skin |
- Prior Authorization: Myelofibrosis:
Documented Diagnosis: Yes
Medical Test Required: Yes
Duration: 6 Month(s)
Reauthorization Required: Yes
- Prior Authorization: PA_APPLIES
- Quantity Limit: 204 lancets per 30 day(s).
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