Health Net
Palforzia (120 MG Daily Dose) (peanut allergen powder-dnfp)
Biological Agents : Biological Agents
  • Peanut Allergy:
    Age Requirement: >= 4
    Duration: 6 Month(s)
    Specialist Required: Yes
    Documented Diagnosis: Yes
    Medical Test Required: Yes
    Reauthorization Required: Yes
    Duration of Reauthorization: = 12 month(s)

  • Prior Authorization: Peanut Allergy:
    Documented Diagnosis: Yes
    Medical Test Required: Yes
    Age Requirement: >= 4
    Duration: 6 Month(s)
    Reauthorization Required: Yes