- Step Therapy: Psychiatry: Schizophrenia:
ST Single Generic
- Prior Authorization: Psychiatry: Schizophrenia:
Documented Diagnosis: Yes
Age Requirement: >= 18
Duration: 6 Month(s)
Reauthorization Required: Yes
- Psychiatry: Schizophrenia:
Age Requirement: >= 18
Duration: 6 Month(s)
Specialist Required: Yes
Medical Test Required: No
Specialist Type(s): Physiatrist
Specialty Pharmacy Provider(s): AcariaHealth
Reauthorization Required: Yes
Duration of Reauthorization: = 12 month(s)
Policy Requires Documentation of Patient Noncompliance to Oral Therapy: Yes
Established tolerability to oral formulation: Yes
Documented Diagnosis: Yes
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