Health Net
Signifor LAR (pasireotide pamoate)
Hormones : Drugs for Growth
  • Prior Authorization: Documented Diagnosis: Yes
    Age Requirement: >= 18
    Duration: 6 Month(s)
    Reauthorization Required: Yes

  • Acromegaly:
    Age Requirement: >= 18
    Duration: 6 Month(s)
    Specialist Required: Yes
    Documented Diagnosis: Yes
    Medical Test Required: No
    Specialist Type(s): Endocrinologist
    Reauthorization Required: Yes
    Duration of Reauthorization: <= 6 month(s)

    Cushings Syndrome:
    Age Requirement: >= 18
    Duration: 6 Month(s)
    Specialist Required: Yes
    Documented Diagnosis: Yes
    Medical Test Required: No
    Specialist Type(s): Endocrinologist
    Reauthorization Required: Yes
    Duration of Reauthorization: >= 6 month(s)

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