UnitedHealthcare
Valchlor (mechlorethamine)
Drugs for the Skin : Drugs for the Skin
  • Prior Authorization: Cutaneous T-Cell Lymphomas:
    Documented Diagnosis: Yes
    Duration: 12 Month(s)
    Reauthorization Required: Yes

  • Cutaneous T-Cell Lymphomas:
    Duration: 12 Month(s)
    Documented Diagnosis: Yes
    Medical Test Required: No
    Reauthorization Required: Yes
    Duration of Reauthorization: = 12 month(s)