- Prior Authorization: Multiple Sclerosis (MS):
Documented Diagnosis: Yes
Duration: 1 plan year
Reauthorization Required: Yes
- Step Therapy: Multiple Sclerosis (MS):
ST Multiple Brands
- Multiple Sclerosis (MS):
Duration: 1 plan year
Documented Diagnosis: Yes
Medical Test Required: No
Reauthorization Required: Yes
Duration of Reauthorization: = 1 plan year
Patients Cardiac Medical History Required: No
Concomitant use of other MS medication: No
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