UnitedHealthcare
Hydrea (hydroxyurea)
Drugs for Cancer : Drugs for Cancer
  • Hereditary Angioedema (HAE):
    Age Requirement: >= 12
    Duration: 6 Month(s)
    Specialist Required: Yes
    Documented Diagnosis: Yes
    Medical Test Required: Yes
    Specialist Type(s): 1 of Allergist;Hematologist;Immunologist
    Reauthorization Required: Yes
    Duration of Reauthorization: <= 6 month(s)
    Diagnosis Type(s): Treatment of Acute HAE Attacks
    HAE Type: Unspecified
    Documented Lab Values: 2 of Low C1-INH Antigenic Level;Low C1-INH Functional Level;Low C4 Level;Normal C1-INH level;Normal C4 level
    History of Moderate or Severe Attacks: No