| Anthem Blue Cross (HMO, PPO, EPO) |
| Rhofade (oxymetazoline) |
| Drugs for the Skin : Drugs for the Skin |
- Step Therapy: Derm: Rosacea:
Step Applies
- Derm: Rosacea:
Duration: 1 year(s)
Documented Diagnosis: No
Medical Test Required: No
Reauthorization Required: No
Duration of Reauthorization: N/A
- Prior Authorization: Derm: Rosacea:
PA Applies
- Quantity Limit: 60 grams per 30 day(s).
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