Anthem Blue Cross (HMO, PPO, EPO) |
Invega Trinza (paliperidone palm (3-month)) |
Drugs for the Nervous System : Drugs for Severe Mental Disorders |
- Prior Authorization: Psychiatry: Schizophrenia:
Age Requirement: >= 18
Duration: 1 year(s)
- Step Therapy: Psychiatry: Schizophrenia:
ST Single Generic
- Quantity Limit: 1 syringe per 90 day(s).
- Psychiatry: Schizophrenia:
Age Requirement: >= 18
Duration: 1 year(s)
Medical Test Required: No
Reauthorization Required: No
Policy Requires Documentation of Patient Noncompliance to Oral Therapy: No
Established tolerability to oral formulation: No
Documented Diagnosis: No
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