| Anthem Blue Cross (HMO, PPO, EPO) |
| Rasuvo (PF) 27.5 Mg/0.55 Ml Atin (methotrexate (PF)) |
| Drugs for Pain and Fever : Arthritis and Pain Drugs |
- Prior Authorization: Documented Diagnosis: Yes
Duration: 1 year(s)
- Duration: 1 year(s)
Documented Diagnosis: Yes
Medical Test Required: No
Reauthorization Required: No
Duration of Reauthorization: N/A
TB Test required: No
- Step Therapy: ST Multiple Generics
|