Sharp Health Plan
Ampyra (dalfampridine)
Drugs for the Nervous System : Drugs for Multiple Sclerosis
  • Prior Authorization: Multiple Sclerosis (MS):
    PA Applies

  • Multiple Sclerosis (MS):
    Documented Diagnosis: No
    Medical Test Required: No
    Reauthorization Required: No
    Patients Cardiac Medical History Required: No
    Concomitant use of other MS medication: No

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