| Anthem Blue Cross (HMO, PPO, EPO) |
| Otrexup (PF) 7.5 Mg/0.4 Ml Atin (methotrexate (PF)) |
| Drugs for Pain and Fever : Arthritis and Pain Drugs |
- Prior Authorization: Documented Diagnosis: Yes
Duration: 1 year(s)
- Step Therapy: ST Multiple Generics
- Duration: 1 year(s)
Documented Diagnosis: Yes
Medical Test Required: No
Reauthorization Required: No
Duration of Reauthorization: N/A
TB Test required: No
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