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Chemistry / Antiretroviral drug / Viral load / HIV / Zidovudine / Pharmacy / Compliance / Enfuvirtide / HIV/AIDS / Medicine / Health


Passport Health Plan Prior Authorization Fuzeon® Procedure and Required Information, HIV RNA Tracking, and Medication History (Documenting Failure to Oral Anti-Retroviral Therapy)
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Document Date: 2014-03-31 16:23:21

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File Size: 198,52 KB

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City

Glen Allen / /

Company

Magellan Pharmacy Solutions / /

Facility

Local Pharmacy / /

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MedicalCondition

HIV-RNA / HIV / HIV RNA / /

MedicalTreatment

drug therapy / Anti-Retroviral Therapy / /

Organization

OF SERVICE / /

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Position

Physician / /

Product

Fuzeon / Levels HIV-RNA Level CD4 Level Comments/Observed Clinical Improvements Subsequent Reauthorization Medication / /

ProvinceOrState

Virginia / /

Technology

genotype / /

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