- Bowel Prep:
Duration: 1 year(s)
Medical Test Required: No
Reauthorization Required: No
Duration of Reauthorization: N/A
A medical condition requires electrolyte combination that is not present in formulary products: No
Is the patient using for bowel cleansing prior to colonoscopy: No
Documented Diagnosis: Yes
Patient has experienced intolerance to the generic agents: Yes
Patient has experienced intolerance to the preferred brand: No
Trial with PEG product required: No
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