| HealthNet - All plan years |
| ZTlido (lidocaine) |
| Drugs for the Skin : Drugs for the Skin |
- Quantity Limit: 2 tablets per 1 day(s).
- Prior Authorization: PA_APPLIES
- Diabetic Medical Supplies:
Duration: 1 year(s)
Documented Diagnosis: No
Medical Test Required: No
Reauthorization Required: No
Duration of Reauthorization: N/A
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