| Anthem Blue Cross (HMO, PPO, EPO) |
| droxidopa (droxidopa) |
| Drugs for the Heart : Drugs for Serious Allergic Reaction |
- Limited Distribution. Drugs can only be obtained at certain specialty pharmacies.
- ADHD:
Age Requirement: >= 13
Duration: 1 plan year
Documented Diagnosis: Yes
Medical Test Required: No
Reauthorization Required: Yes
Duration of Reauthorization: = 1 plan year
- Step Therapy: ST_APPLIES
- Split Fill;
|