UnitedHealthcare
Spravato 28 Mg Spry (esketamine)
Drugs for the Nervous System : Drugs for Depression
  • Major Depressive Disorder:
    Duration: 3 Month(s)
    Specialist Required: Yes
    Medical Test Required: No
    Specialist Type(s): 1 of Psychiatrist
    Reauthorization Required: Yes
    Duration of Reauthorization: = 6 month(s)
    Documented Diagnosis: Yes

  • Step Therapy: Major Depressive Disorder:
    Step Applies
  • Prior Authorization: Major Depressive Disorder:
    PA Applies