Limited Use Note(s)

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Reason For Use CodeClinical Criteria
399Outpatient continuation of treatment for documented invasive aspergillosis in patients who have demonstrated a clinical response to either oral or parenteral voriconazole. * The first prescription must be written by a physician based at the hospital where the patient was hospitalized. Note: Limited to 3 months of reimbursement.
LU Authorization Period: 1 year