Limited Coverage Drugs - Special Authority Criteria
|
Generic Name / Strength / Form |
|
|---|---|
|
risedronate 30mg |
| Criteria | Approval Period |
|---|---|
|
Diagnosis of Paget's disease |
Indefinite |
Practitioner Exemptions
- No practitioner exemptions
Special Notes
- None
Special Authority Request Form(s)
Online Forms (PDF, 523KB)
Click on the link to complete a special authority request form.
