- Step Therapy Applies
- PA Required
- Rheumatoid Arthritis (RA):
Age Requirement: >= 18
Duration: 3 Month(s)
Specialist Required: Yes
Documented Diagnosis: Yes
Medical Test Required: Yes
Specialist Type(s): Rheumatologist
Reauthorization Required: Yes
Duration of Reauthorization: = 1 year(s)
TB Test required: Yes
- Available through Specialty Pharmacy;
- Quantity Limit: 30 day supply per 1 fill(s).
- Prior Authorization: Rheumatoid Arthritis (RA):
Documented Diagnosis: Yes
Medical Test Required: Yes
Age Requirement: >= 18
Duration: 3 Month(s)
Reauthorization Required: Yes
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