| Sutter Health Plus |
| Daytrana (methylphenidate) |
| Drugs for the Nervous System : Drugs for Attention Deficit Disorder |
- Ophthalmic: Dry Eye:
Duration: 6 Month(s)
Specialist Required: Yes
Documented Diagnosis: Yes
Medical Test Required: No
Specialist Type(s): 1 of Ophthalmologist;Optometrist;Rheumatologist
Reauthorization Required: Yes
Duration of Reauthorization: = 12 month(s)
- Oral anti-cancer drug.
- Quantity Limit: limit maximum 60 mL PER 1 day(s)
- Quantity Limit: limit maximum 3 EA PER 1 day(s)
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