UnitedHealthcare
Lupron Depot (1-Month) (leuprolide)
Hormones : Drugs for Women
  • ST_APPLIES
  • Alpha-1 Antitrypsin Deficiency:
    Duration: 1 year(s)
    Medical Test Required: No
    Reauthorization Required: No
    Duration of Reauthorization: N/A
    Required Evidence of Emphysema: No
    Documented Serum AAT Level: N/A
    Policy Required Patient Must be a Non-smoker: No
    Documented Diagnosis: No

  • Step Therapy: Psychiatry: Schizophrenia:
    ST Multiple Generics

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