- Crohn's Disease (CD):
Age Requirement: > 18
Duration: 12 Month(s)
Documented Diagnosis: No
Medical Test Required: No
Reauthorization Required: No
TB Test required: No
Psoriatic Arthritis (PsA): Duration: 12 Month(s)
Documented Diagnosis: No
Medical Test Required: No
Reauthorization Required: No
Duration of Reauthorization: N/A
TB Test required: No
Rheumatoid Arthritis (RA): Documented Diagnosis: No
Medical Test Required: No
Reauthorization Required: No
Duration of Reauthorization: N/A
TB Test required: No
- Prior Authorization: Crohn's Disease (CD):
Age Requirement: > 18
Duration: 12 Month(s)
Psoriatic Arthritis (PsA): Duration: 12 Month(s)
Rheumatoid Arthritis (RA): PA Applies
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