- Prior Authorization: Behcet's Disease:
Documented Diagnosis: Yes
Age Requirement: >= 18
Duration: 6 Month(s)
Reauthorization Required: Yes
Psoriasis (PsO): Documented Diagnosis: Yes
Age Requirement: >= 18
Duration: 6 Month(s)
Psoriatic Arthritis (PsA): Documented Diagnosis: Yes
Age Requirement: >= 18
Duration: 1 plan year
Reauthorization Required: Yes
- Step Therapy: ST Generic and Brand
- Step Therapy: ST_APPLIES
- Quantity Limit: limit maximum 1 EA PER 1 day(s)
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