| Anthem Blue Cross (HMO, PPO, EPO) |
| adapalene-benzoyl peroxide (adapalene-benzoyl peroxide) |
| Drugs for the Skin : Drugs for the Skin |
- Prior Authorization: Migraine:
Documented Diagnosis: Yes
Duration: 6 Month(s)
Reauthorization Required: Yes
Migraine Prevention:
Documented Diagnosis: Yes
Duration: 6 Month(s)
|