मेडइम्पॅक्ट स्टँडर्ड कमर्शियल ड्रग फॉर्म्युलरी आधी अधिकृतता मार्गदर्शक तत्त्वे सूचना
STANDARD COMMERCIAL DRUG FORMULARY PRIOR AUTHORIZATION GUIDELINES Standard Commercial Drug Formulary Prior Authorization Guidelines ADALIMUMAB Generic Brand HICL GCN Medi-Span Exception/Other ADALIMUMAB HUMIRA 24800 GPI-10 (6627001500) GUIDELINES FOR USE INITIAL CRITERIA (NOTE: FOR RENEWAL CRITERIA SEE BELOW) Does the patient…