Anthem Blue Cross (HMO, PPO, EPO)
Tavneos (avacopan)
Drugs for Pain and Fever : Arthritis and Pain Drugs

  • For FAX form click HERE
    Our electronic prior authorization (ePA) process is the preferred method for submitting pharmacy prior authorization requests. Creating an account is free, easy and helps patients get their medications sooner. You can complete the process through your current electronic health record/electronic medical record (EHR/EMR) system or by using one of these ePA sites:
     Log in to Surescripts
     Log in to CoverMyMeds; For details on drug coverage click HERE;
  • Age Requirement: >= 18
    Duration: 1 year(s)
    Specialist Required: Yes
    Documented Diagnosis: Yes
    Medical Test Required: No
    Specialist Type(s): 1 of Nephrologist;Rheumatologist
    Reauthorization Required: No
    Duration of Reauthorization: N/A

  • PA Applies
  • Prior Authorization: Documented Diagnosis: Yes
    Age Requirement: >= 18
    Duration: 1 year(s)

  • Quantity Limit: 6 capsules per 1 day(s).