- 1; 1;
- PA Applies
- Duchenne Muscular Dystrophy (DMD):
Age Requirement: >= 6
Duration: 6 Month(s)
Documented Diagnosis: Yes
Medical Test Required: Yes
Reauthorization Required: Yes
Duration of Reauthorization: Unspecified
Specialty Pharmacy is Required: Not Defined
- Prior Authorization: PA_APPLIES
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