Health Net
Dyanavel XR (amphetamine)
Drugs for the Nervous System : Drugs for Attention Deficit Disorder
  • Step Therapy: ADHD:
    ST Multiple Generics

  • ADHD:
    Age Requirement: >= 6
    Duration: 1 plan year
    Documented Diagnosis: Yes
    Medical Test Required: No
    Reauthorization Required: Yes
    Duration of Reauthorization: = 1 plan year

  • Prior Authorization: ADHD:
    Documented Diagnosis: Yes
    Age Requirement: >= 6
    Duration: 1 plan year
    Reauthorization Required: Yes