- Obesity:
Age Requirement: >= 12
Duration: 6 Month(s)
Documented Diagnosis: Yes
Medical Test Required: No
Reauthorization Required: Yes
Duration of Reauthorization: = 6 month(s)
- Prior Authorization: Obesity:
Documented Diagnosis: Yes
Age Requirement: >= 12
Duration: 6 Month(s)
Reauthorization Required: Yes
- Step Therapy: Obesity:
ST Single Brand
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