| Sutter Health Plus |
| Vumerity (Starter) (diroximel fumarate) |
| Drugs for the Nervous System : Drugs for Multiple Sclerosis |
- May be covered under Medical Benefit.
- 1;
- Quantity Limit: limit maximum 4 ML PER 30 day(s)
- Quantity Limit: 204 strips per 30 day(s).
- Cutaneous T-Cell Lymphomas:
Age Requirement: >= 18
Specialist Required: Yes
Documented Diagnosis: Yes
Medical Test Required: No
Specialist Type(s): 1 of Hematologist;Oncologist
Reauthorization Required: Yes
Duration of Reauthorization: Unspecified
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