Anthem Blue Cross (HMO, PPO, EPO)
Nalocet (oxycodone-acetaminophen)
Drugs for Pain and Fever : Arthritis and Pain Drugs
  • Quantity Limit: 6 tablets per 1 day(s).
  • Pain Narcotic: Opioid:
    Duration: 3 Month(s)
    Documented Diagnosis: Yes
    Medical Test Required: No
    Reauthorization Required: No
    Duration of Reauthorization: = 6 month(s)
    Diagnosis Type(s): Unspecified
    Used for Cancer Patients: Yes
    Around-The-Clock Analgesic Required: No
    Morphine Equivalent Dose (MED) Limit: N/A
    Morphine Equivalent Dose (MED) Required: No

  • Prior Authorization: Pain Narcotic: Opioid:
    Documented Diagnosis: Yes
    Duration: 3 Month(s)