Health Net
Diovan HCT (valsartan-hydrochlorothiazide)
Drugs for the Heart : Drugs for High Blood Pressure
  • Quantity Limit: limit maximum 3 EA PER fill retail
  • Prior Authorization: CIDP: Immune Globulin:
    PA Applies Immune Thrombocytopenic Purpura (ITP):
    Documented Diagnosis: Yes
    Duration: 6 Month(s)

    Pemphigus Vulgaris, PID: Immune Globulin:
    Documented Diagnosis: Yes
    Duration: 6 Month(s)
    Reauthorization Required: Yes