- Prior Authorization: Gouty Arthritis:
Documented Diagnosis: Yes
Duration: 12 Month(s)
Reauthorization Required: Yes
- Step Therapy: Gouty Arthritis:
ST Multiple Generics
- Gouty Arthritis:
Duration: 12 Month(s)
Specialist Required: Yes
Documented Diagnosis: Yes
Medical Test Required: No
Specialist Type(s): 1 of Nephrologist;Rheumatologist
Reauthorization Required: Yes
Duration of Reauthorization: Unspecified
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