Health Net |
Valtoco 15 MG Dose (diazepam) |
Drugs for the Nervous System : Drugs for Seizures /Personality Disorder/Nerve Pain |
- Prior Authorization: Cluster Seizure/Seizure Emergency:
Documented Diagnosis: Yes
Age Requirement: >= 6
Duration: 6 Month(s)
Reauthorization Required: Yes
- Cluster Seizure/Seizure Emergency:
Age Requirement: >= 6
Duration: 6 Month(s)
Specialist Required: Yes
Documented Diagnosis: Yes
Medical Test Required: No
Specialist Type(s): Neurologist
Reauthorization Required: Yes
Duration of Reauthorization: = 12 month(s)
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