Limited Use Note(s) |
|
Limited Use Note(s) |
|
| Reason For Use Code | Clinical Criteria |
|---|---|
| 511 | For the treatment of chronic pain in patients who cannot tolerate, or have failed treatment with a long-acting opioid. Intolerance or failed treatment with a long-acting opioid will be subject to verification at the time of dispensing. |
| LU Authorization Period: 1 year |