Health Net
Valtoco 10 MG Dose (diazepam)
Drugs for the Nervous System : Drugs for Seizures /Personality Disorder/Nerve Pain
  • Cluster Seizure/Seizure Emergency:
    Age Requirement: >= 6
    Duration: 6 Month(s)
    Specialist Required: Yes
    Documented Diagnosis: Yes
    Medical Test Required: No
    Specialist Type(s): Neurologist
    Reauthorization Required: Yes
    Duration of Reauthorization: = 12 month(s)

  • Prior Authorization: Cluster Seizure/Seizure Emergency:
    Documented Diagnosis: Yes
    Age Requirement: >= 6
    Duration: 6 Month(s)
    Reauthorization Required: Yes

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