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What prior authorization forms ask for A review of prior authorization forms currently used by Florida Medicaid, Ohio Medicaid, Iowa Medicaid, and Louisiana Medicaid turns up a fairly consistent list of what plans still want on file: a detectable HCV RNA result within a defined window (commonly 12 months, sometimes as tight as 180 days), the HCV genotype where the plan still requires it, whether the patient is treatment-naive or treatment-experienced (and if experienced, the prior regimen, duration, and response), fibrosis stage, and a Child-Pugh score when cirrhosis is documented

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Size:90CT

GS: glutamine synthetase