- Quantity Limit: 1 capsule per 1 day(s).
- Multiple Sclerosis (MS):
Duration: 12 Month(s)
Documented Diagnosis: No
Medical Test Required: No
Reauthorization Required: No
Patients Cardiac Medical History Required: No
Concomitant use of other MS medication: No
- Prior Authorization: PA Required
- Prior Authorization: PA Required
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