- Quantity Limit: limit maximum 1 GM PER 30 day(s)
- Step Therapy: ST_APPLIES
- Ankylosing Spondylitis (AS):
Age Requirement: >= 18
Duration: 6 Month(s)
Specialist Required: Yes
Documented Diagnosis: Yes
Medical Test Required: No
Specialist Type(s): Rheumatologist
Reauthorization Required: Yes
Duration of Reauthorization: = 6 month(s)
TB Test required: No
- Available only through Specialty Pharmacy;
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