Health Net
Doryx MPC (doxycycline hyclate)
Drugs for Infections : Antibiotics
  • Step Therapy Applies
  • Prior Authorization: Derm: Acne Vulgaris:
    Documented Diagnosis: Yes
    Duration: 12 Month(s)

  • Derm: Acne Vulgaris:
    Duration: 12 Month(s)
    Documented Diagnosis: Yes
    Medical Test Required: No
    Reauthorization Required: No
    Duration of Reauthorization: N/A
    Limited to non-cosmetic use: No

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