UnitedHealthcare
Zorbtive (somatropin)
Hormones : Drugs for Growth
  • Prior Authorization: Growth Hormone Deficiency:
    PA Applies

    Short Bowel Syndrome:
    Documented Diagnosis: Yes
    Duration: 4 week(s)

  • Growth Hormone Deficiency:
    Reauthorization Required: No
    Duration of Reauthorization: N/A
    Pediatric - GH Stimulation Test: N/A
    Pediatric - Pituitary Hormone Deficiency: N/A
    Adult - GHD Stimulation Test: N/A
    Adult - Pituitary Hormone Deficiency: N/A
    Adult - Duration of Initial Authorization: N/A
    Adult - Duration of Reauthorization: N/A
    Documented Diagnosis of Other Approved Indications: Short Bowel Syndrome (SBS)
    Documented Diagnosis: No

    Short Bowel Syndrome:
    Duration: 4 week(s)
    Documented Diagnosis: Yes
    Medical Test Required: No
    Reauthorization Required: No
    Duration of Reauthorization: N/A

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