Health Net
Tanzeum 50 Mg/0.5 Ml Pnij (albiglutide)
Hormones : Drugs for Diabetes
  • Step Therapy Applies
  • Prior Authorization: Diabetes Type 2: GLP1 + Combo:
    Documented Diagnosis: Yes
    Duration: 6 Month(s)
    Reauthorization Required: Yes

  • Diabetes Type 2: GLP1 + Combo:
    Duration: 6 Month(s)
    Documented Diagnosis: Yes
    Medical Test Required: No
    Reauthorization Required: Yes
    Duration of Reauthorization: = 6 month(s)
    Supporting Documentation Requirements: 3 of Lab Tests;Medical Tests;Medication History