UnitedHealthcare
Purixan (mercaptopurine)
Drugs for Cancer : Drugs for Cancer
  • Quantity Limit: limit maximum 3 EA PER fill retail
  • Prior Authorization: Migraine:
    Documented Diagnosis: Yes
    Age Requirement: >= 18
    Duration: 3 Month(s)
    Reauthorization Required: Yes

    Migraine Prevention:
    Documented Diagnosis: Yes
    Age Requirement: >= 18
    Duration: 3 Month(s)

<< Return | Back to top