Remodulin
| Covered Uses: | All FDA-approved indications not otherwise excluded from Part D. |
| Exclusion Criteria: | |
| Required Medical Information: | |
| Age Restrictions: | |
| Prescriber Restrictions: | Coverage is provided in situations where it is being prescribed under the care or referral of a cardiologist or pulmonologist. |
| Coverage Duration: | 12 months |
| Other Criteria: | Coverage is provided for use in combination with two or more PAH therapies when treatment with one PAH agent failed to adequately control the patient’s symptoms. |
Last Modified on 12/19/2012