- Prior Authorization: Rheumatoid Arthritis (RA):
Documented Diagnosis: Yes
Duration: 12 Month(s)
Reauthorization Required: Yes
- Quantity Limit: limit maximum 1 EA PER 1 day(s)
- Rheumatoid Arthritis (RA):
Duration: 12 Month(s)
Specialist Required: Yes
Documented Diagnosis: Yes
Medical Test Required: No
Specialist Type(s): Rheumatologist
Reauthorization Required: Yes
Duration of Reauthorization: = 12 month(s)
TB Test required: No
- Step Therapy: Rheumatoid Arthritis (RA):
ST Generic and Brand
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