Health Net
Radicava (edaravone)
Drugs for Nerves and Muscles : Drugs for Nerves and Muscles
  • Amyotrophic Lateral Sclerosis (ALS):
    Age Requirement: >= 20
    Duration: 6 Month(s)
    Specialist Required: Yes
    Documented Diagnosis: Yes
    Medical Test Required: Yes
    Specialist Type(s): Neurologist
    Reauthorization Required: Yes
    Duration of Reauthorization: = 6 month(s)

  • Prior Authorization: Amyotrophic Lateral Sclerosis (ALS):
    Documented Diagnosis: Yes
    Medical Test Required: Yes
    Age Requirement: >= 20
    Duration: 6 Month(s)
    Reauthorization Required: Yes

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