| Anthem Blue Cross (HMO, PPO, EPO) |
| Nuedexta (dextromethorphan-quinidine) |
| Drugs for the Nervous System : Drugs for Severe Mental Disorders |
- Prior Authorization: ADHD:
Documented Diagnosis: Yes
Duration: 12 Month(s)
- Available through Specialty Pharmacy;
- Quantity Limit: limit maximum 6 EA PER 1 day(s)
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