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RESTAT helps clients manage their drug spend by limiting certain drugs and drug classes by either quantity, prior authorization or via step edits.
For each of these products and classes, specific criteria must be met in order for the medication to be considered a covered benefit. The specific criteria may be related to any of the following: diagnosis, trial of an alternative product, lab values, height and weight of the patient and others:
Below is a list of medications requiring quantity limits, step edits or prior authorization. Please click on the drug or drug category name to download the appropriate form to submit to RESTAT Clinical Services for coverage consideration:
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