Limited Use Note(s) |
|
VORICONAZOLE50mg Tab
| Reason For Use Code | Clinical Criteria |
|---|---|
| 399 | Outpatient 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 |