- 1;
- Prior Authorization: Gaucher Disease:
Documented Diagnosis: Yes
Medical Test Required: Yes
Age Requirement: >= 18
Duration: 1 year(s)
Reauthorization Required: Yes
- Quantity Limit: Limit 45gms pe month;QL(1.5gm daily)
- Quantity Limit: limit maximum 0.30 EA PER 1 day(s)
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