Health Net
Tolak (fluorouracil)
Drugs for the Skin : Drugs for the Skin
  • Actinic Keratosis:
    Duration: 4 week(s)
    Documented Diagnosis: Yes
    Medical Test Required: No
    Reauthorization Required: Yes
    Duration of Reauthorization: <= 4 week(s)

  • Prior Authorization: Actinic Keratosis:
    Documented Diagnosis: Yes
    Duration: 4 week(s)
    Reauthorization Required: Yes

  • Step Therapy: Actinic Keratosis:
    ST Single Generic

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