| UnitedHealthcare - 2014 to Present |
| Quillivant XR (methylphenidate HCl) |
| Drugs for the Nervous System : Drugs for Attention Deficit Disorder |
- PA_APPLIES
- PA Required
- Diabetes Type 2: Short Acting Insulin (Meal-time):
Duration: 1 year(s)
Documented Diagnosis: Yes
Medical Test Required: No
Reauthorization Required: No
Duration of Reauthorization: N/A
- Prior Authorization: PA Applies
|