UnitedHealthcare
Nuplazid (pimavanserin)
Drugs for the Nervous System : Drugs for Severe Mental Disorders
  • Prior Authorization: Parkinsons Psychosis:
    Documented Diagnosis: Yes
    Duration: 12 Month(s)
    Reauthorization Required: Yes

  • Quantity Limit: limit maximum 2 EA PER 1 day(s)
  • Parkinsons Psychosis:
    Duration: 12 Month(s)
    Documented Diagnosis: Yes
    Medical Test Required: No
    Reauthorization Required: Yes
    Duration of Reauthorization: = 12 month(s)

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