Health Net
Acticlate (doxycycline hyclate)
Drugs for Infections : Antibiotics
  • Derm: Acne Vulgaris:
    Documented Diagnosis: No
    Medical Test Required: No
    Reauthorization Required: No
    Limited to non-cosmetic use: No

  • Step Therapy: Derm: Acne Vulgaris:
    ST Single Generic

  • Prior Authorization: Derm: Acne Vulgaris:
    PA Applies

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