- Prior Authorization: Chorea in Huntington's Disease:
Documented Diagnosis: Yes
Duration: 1 year(s)
Tardive Dyskinesia (TD): Documented Diagnosis: Yes
Duration: 1 year(s)
Reauthorization Required: Yes
- Quantity Limit: 2 inhalers per 30 day(s).
- Diabetes Type 2: GLP1 + Combo:
Age Requirement: >= 18
Duration: 1 year(s)
Documented Diagnosis: Yes
Medical Test Required: No
Reauthorization Required: Yes
Duration of Reauthorization: = 1 year(s)
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