UnitedHealthcare
Januvia (sitagliptin)
Hormones : Drugs for Diabetes
  • Prior Authorization: CIDP: Immune Globulin:
    PA Applies Immune Thrombocytopenic Purpura (ITP):
    Documented Diagnosis: Yes
    Duration: 6 Month(s)

    Pemphigus Vulgaris, PID: Immune Globulin:
    Documented Diagnosis: Yes
    Duration: 6 Month(s)
    Reauthorization Required: Yes

  • Step Therapy: Hemophilia A (Factor VIII):
    ST Multiple Brands

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