Health Net
Bylvay (odevixibat)
Drugs for the Liver : Drugs for the Liver
  • Prior Authorization: Cholestatic Liver Disease:
    Documented Diagnosis: Yes
    Medical Test Required: Yes
    Duration: 6 Month(s)
    Reauthorization Required: Yes

  • Cholestatic Liver Disease:
    Duration: 6 Month(s)
    Specialist Required: Yes
    Documented Diagnosis: Yes
    Medical Test Required: Yes
    Specialist Type(s): 1 of Gastroenterologist;Hepatologist
    Reauthorization Required: Yes
    Duration of Reauthorization: = 12 month(s)

<< Return | Back to top