Health Net
Palynziq (pegvaliase-pqpz)
Drugs that Alter Metabolism : Drugs that Alter Metabolism
  • Phenylketonuria (PKU):
    Age Requirement: >= 18
    Duration: 12 Month(s)
    Specialist Required: Yes
    Documented Diagnosis: Yes
    Medical Test Required: Yes
    Specialist Type(s): 1 of Endocrinologist;Geneticist;Metabolic Specialist
    Reauthorization Required: Yes
    Duration of Reauthorization: = 12 month(s)

  • Prior Authorization: Phenylketonuria (PKU):
    Documented Diagnosis: Yes
    Medical Test Required: Yes
    Age Requirement: >= 18
    Duration: 12 Month(s)
    Reauthorization Required: Yes