UnitedHealthcare
Palynziq (pegvaliase-pqpz)
Drugs that Alter Metabolism : Drugs that Alter Metabolism
  • Phenylketonuria (PKU):
    Duration: 12 Month(s)
    Documented Diagnosis: Yes
    Medical Test Required: Yes
    Reauthorization Required: Yes
    Duration of Reauthorization: = 12 month(s)

  • Prior Authorization: Phenylketonuria (PKU):
    Documented Diagnosis: Yes
    Medical Test Required: Yes
    Duration: 12 Month(s)
    Reauthorization Required: Yes

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