Health Net
Forfivo XL (bupropion HCl)
Drugs for the Nervous System : Drugs for Depression
  • ADHD:
    Age Requirement: >= 6
    Duration: 1 plan year
    Documented Diagnosis: Yes
    Medical Test Required: No
    Reauthorization Required: Yes
    Duration of Reauthorization: = 1 plan year

  • Prior Authorization: Documented Diagnosis: Yes
    Duration: 1 year(s)

  • Prior Authorization: PA_APPLIES