Anthem Blue Cross (HMO, PPO, EPO) |
Arymo ER (morphine) |
Drugs for Pain and Fever : Arthritis and Pain Drugs |
- Prior Authorization: Pain Narcotic: Opioid:
Duration: 1 year(s)
- Pain Narcotic: Opioid:
Duration: 1 year(s)
Documented Diagnosis: No
Medical Test Required: No
Reauthorization Required: No
Duration of Reauthorization: N/A
Used for Cancer Patients: No
Around-The-Clock Analgesic Required: No
Morphine Equivalent Dose (MED) Limit: N/A
Morphine Equivalent Dose (MED) Required: No
- Quantity Limit: 3 tablets per 1 day(s).
- Step Therapy: Pain Narcotic: Opioid:
ST Multiple Generics
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