UnitedHealthcare
capecitabine (capecitabine)
Drugs for Cancer : Drugs for Cancer
  • PA_APPLIES
  • Prior Authorization: Juvenile Idiopathic Arthritis:
    Documented Diagnosis: Yes
    Age Requirement: >= 2
    Duration: 1 plan year
    Reauthorization Required: Yes

    Psoriasis (PsO):
    Documented Diagnosis: Yes
    Duration: 1 plan year

    Rheumatoid Arthritis (RA):
    Documented Diagnosis: Yes
    Age Requirement: >= 2
    Duration: 6 Month(s)
    Reauthorization Required: Yes

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