- Prior Authorization Required
- COPD (oral):
Duration: 1 plan year
Medical Test Required: No
Reauthorization Required: Yes
Duration of Reauthorization: = 12 month(s)
COPD associated with chronic bronchitis: No
History of COPD exacerbation: No
Documented Diagnosis: Yes
- Step Therapy: COPD (oral):
1 of [LAMA-LABA Combination]
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