- Prior Authorization: Hypertension (High Blood Pressure):
Documented Diagnosis: Yes
Duration: 12 Month(s)
Reauthorization Required: Yes
- Prior Authorization: PA Required
- Prior Authorization: Ankylosing Spondylitis (AS), Crohn's Disease (CD), Psoriasis (PsO), Psoriatic Arthritis (PsA), Rheumatoid Arthritis (RA):
Documented Diagnosis: Yes
Duration: 1 year(s)
Nonradiographic Axial Spondyloarthritis:
Duration: 1 year(s)
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