UnitedHealthcare
Somavert (pegvisomant)
Hormones : Drugs for Growth
  • Prior Authorization: Acromegaly:
    Documented Diagnosis: Yes
    Duration: 12 Month(s)
    Reauthorization Required: Yes

  • Acromegaly:
    Duration: 12 Month(s)
    Documented Diagnosis: Yes
    Medical Test Required: No
    Reauthorization Required: Yes
    Duration of Reauthorization: = 12 month(s)