| Anthem Blue Cross (HMO, PPO, EPO) |
| Nuplazid (pimavanserin) |
| Drugs for the Nervous System : Drugs for Severe Mental Disorders |
- Prior Authorization: Parkinsons Psychosis:
Documented Diagnosis: Yes
Duration: 1 year(s)
- Quantity Limit: 2 tablets per 1 day(s).
- Step Therapy: Parkinsons Psychosis:
ST Multiple Generics
- Parkinsons Psychosis:
Duration: 1 year(s)
Documented Diagnosis: Yes
Medical Test Required: No
Reauthorization Required: No
Duration of Reauthorization: N/A
- Available only through Specialty Pharmacy;
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